MAGMA: This phase III trial is trying to understand whether to give glioblastoma patients chemotherapy as soon as possible following surgery and prior to chemoradiotherapy; and how many cycles of standard adjuvant chemotherapy to give patients after chemoradiotherapyA multi-arm multi-stage, multi-centre, phase III (MAMS) platform trial that aims to assess hypotheses against a common standard-of-care control arm for the management of people with glioblastoma

Exclusion

1. Recurrence of glioblastoma
2. Comorbidities considered to provide a safety concern for use of TMZ, e.g. idiopathic
autoimmune thrombocytopenia or other haematological diease causing cytopaenias
3. Other contraindications to TMZ
4. Cranial irradiation within 2 years prior to registration
5. Other co-morbidities or conditions that may compromise assessment of key outcomes
6. History of another malignancy within 2 years prior to registration. Patients with adequately treated carcinoma-in-situ of the prostate, breast or cervix, melanoma-in-situ, basal cell carcinoma of the skin, squamous cell carcinoma of the skin, non-muscle invasive transitional cell carcinoma of the bladder or low grade prostate cancer not requiring treatment (ISUP 1; Gleason grade less than or equal to 6) may be included in this study.
7. Concurrent illness, including severe or chronic bacterial or viral infection that may jeopardise the ability of the patient to undergo the procedures outlined in this protocol with reasonable safety. Patients with adequately treated hepatitis B, hepatitis C or human immunodeficiency virus at low risk of acquired immunodeficiency syndrome-related outcomes may be included in this study.
8. Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule, including alcohol dependence or drug abuse
9. Pregnancy, lactation, or inadequate contraception. Women must be post-menopausal, infertile, or use a reliable means of contraception. Women of childbearing potential must have a negative pregnancy test done within 7 days prior to registration. Men must have been surgically sterilised or use a (double if required) barrier method of contraception.