Need advice....IDH1+, (maybe) unmethylated GBM..MANY conflicting opinions

I have been reading this message board for years and been impressed with the knowledge of many of the participants.  I was hoping I would never need to post...

As posted by Stephen previously,  my now 25 y/o son was diagnosed in 2011 with OA Grade 2 (now felt to be AA3) and treated with surgery and then surgery to get "leftover" in 2012.  He was found to be IDH1+. Because of the infiltrative nature of tumor on path, he then entered into a clinical trial on the cognitive effects of proton therapy, which he completed 11/12.  No chemo was given.  (No apparent cognitive effects in his case either...did very well in college and is/was in med. school.)  On routine MRI 12/17, he was found to have a 6-7 mm area of enhancement in the middle of his resection cavity (tumor never enhanced before).  Advice was to watch for 2-3 months, but we moved up the surgery.  Note that his tumor grew about 1 mm in each dimension in 6 weeks.  He had a very generous GTR 2/15 and has had a pretty easy recovery--no apparent deficits.
Unfortunately, the path showed GBM IDH1+ unmethylated.  They also looked at his tumor from 2012 and it was also unmethylated.    Foundation One is not back yet.  We have been looking at different options and consulted physicians from several different areas.  Many have been very generous with their time and there is no consensus.  Opinions below...

(he didn't qualify for TOCA due to small tumor size and no prev. treatment)
--Local neuro-onc:  olaparib + Temodar + more proton.  Wasn't really certain of dosing.  (PARADIGM2 could provide that)
--Tumor board at Mass. General....some said NO treatment, some said Temodar.  Told to wait on radiation as scans might be too difficult to interpret
--Physician who is expert on IDH1....feels that IDH1+ GBM shouldn't be considered as really a GBM.  Rec. no radiation and PC(noV) since it has been shown to work.
--Physician at another institution who is involved with IDH1 studies...PCV.  He said to delay radiation because of  "better things coming" and it will probably take radiation + chemo to really eradicate tumor
--Second Opinion from well-regarded cancer institute....PCV has not been shown to work.  Use Temodar and radiation, though consider immunotherapy.
--UCLA...IDH1+ more indolent, possibly PARP + Temodar...perhaps immunotherapy depending on mutation burden.  Not good luck with olaparib, though don't know about mutant status of those patients. Told that IDH1+ SHOULD  be methylated and that test not very accurate.

So....he just missed a slot on the BGB-290(pamiparib) + Temodar (but without radiation) trial...expansion cohort likely opening in 4 weeks.   Evidently fairly well tolerated.  He strongly wants to return to school in August, which seems somewhat unrealistic, but not impossible.  Waiting 4 weeks for treatment doesn't seem like a great idea, unless one accepts the idea that this is a more indolent tumor.

Would really appreciate advice in this matter!  Thanks,   Marcia
(And thank you so much, Stephen!)

BGB-290 (brain penentrant PARP inhibitor) trial now open in USA

Formerly this drug was only available in 2 Australian clinical trials.  A trial has now opened in the USA (Arizona, Colorado, Tennessee, not yet open in Oklahoma) for newly diagnosed GBM with unmethylated MGMT, or for recurrent GBM (methylated/unmethylated MGMT), combined with standard treatments (temozolomide + BGB-290 in the recurrent group).

https://clinicaltrials.gov/ct2/show/NCT03150862

Past post that mentioned BGB-290 and PARP inhibitors.
http://btcocktails.blogspot.com/2017/07/parp-combination-therapy.html

PARP combination therapy

Hello all,

I came across this article:

PARP inhibitor combination therapy

"Here, we summarise both the pre-clinical and clinical evidence for the utility of such combinations and discuss the future prospects and challenges for PARP inhibitor combinatorial therapies."
http://dx.doi.org/10.1016/j.critrevonc.2016.10.010

Does someone have experience regarding PARP combination therapy? I know this has been discussed before in other posts especially when a tumour is IDH1-mutated. In the article they also propose that MGMT methylation is positive factor for PARP therapy.

It would be interesting to see results from trials or hear personal experiences on PARP therapy.

All the best,
Juha