Lymphocyte Re-infusion During Immune Suppression to Treat Metastatic Melanoma

Phase 2

Completed

Conditions: Melanoma
Neoplasm Metastasis

Interventions: Drug: IL-2
Procedure: Apheresis
Biological: Abl cells
Drug: Montanide ISA-51
Drug: Fludarabine
Drug: Cyclophosphamide
Biological: GCSF (Growth colony stimulating factor)

Registration Number: NCT00001832

Lead Sponsor: National Cancer Institute (NCI)

Brief Summary: This experiment will test the safety and effectiveness of a treatment for melanoma in which certain lymphocytes (a type of white blood cell) are taken from the patient, grown in the laboratory, and returned after the patient's immune system has been weakened with immune-suppressing drugs. Some patients will also receive interleukin-2 (IL-2), a drug that may enhance the activity of the re-infused lymphocytes.

Patients with metastatic melanoma (melanoma whose tumor has spread) who have been treated unsuccessfully with gp100 vaccination may participate in this study. They will undergo apheresis or a tumor biopsy, or both, to collect lymphocytes. In apheresis, whole blood is drawn through a needle in the arm. A machine separates the blood components and removes the white cells. The rest of the blood is returned to the donor through a needle in the other arm. A biopsy is a surgical procedure to remove a small piece of tumor tissue.

Several weeks before the lymphocytes are collected, patients will receive injections of growth colony stimulating factor (G-CSF) every day for five days. This drug stimulates white cell production, permitting as many cells as possible to be obtained during collection. The lymphocytes will then be grown in larger numbers in the laboratory.

Seven days before the cells are re-infused, the patient is admitted to the hospital and a catheter (small tube) is placed in a large vein in the chest or neck. Two drugs, cyclophosphamide and fludarabine, are given through the tube. These drugs suppress the immune system so that it will not interfere with the work of the reinfused lymphocytes. The lymphocytes are then injected through the catheter over a 30-minute period. After the infusion, patients who receive IL-2 will be given the drug in a high dose over a 15-minute period every eight hours for up to five days. Patients whose condition does not permit high-dose IL-2, such as those with a heart condition or lung problem, may receive a low-dose regimen, with the drug given as a shot under the skin of the thigh or abdomen for five days followed by a 2-day break, continuing for a total of six weeks. These patients receive a higher dose the first week and then half that dose the next five weeks.

Blood and tissue samples will be taken before and during the study to evaluate the size of the tumor and assess treatment. If, 3-5 weeks after therapy is completed, the patient's tumor has stabilized or shrunk, the entire treatment, except for chemotherapy, may be repeated two more times.

Detailed Description: Patients with metastatic melanoma who are human immunodeficiency virus (HIV) and Hepatitis B negative and who have previously progressed after receiving standard therapy will receive a nonmyeloablative but lymphocyte depleting preparative regimen consisting of cyclophosphamide and fludarabine and then will be treated by the adoptive transfer of lymphocytes reactive with shared antigens on their tumors. This study will evaluate the toxicity, immunologic effects and potential therapeutic role of this treatment.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 170

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Abl Cells IV+Low Dose IV IL-2 (Initial)	IL-2	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (72,000 IU/kg q8h for a maximum of 15 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2 no GCSF	IL-2	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without growth colony stimulating factor (G-CSF) (to determine if G-CSF has harmful effects when adoptively transferring lymphocytes following a nonmyeloablative chemotherapy regimen) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2 no GCSF	IL-2	Abl Cells intravenous (IV) + maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF)(gp100 reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + gp100:209-217(210M) 1mg/day (2-8 days) in patients with gp100 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2	IL-2	Abl Cells intravenous (IV)+ maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1)reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF	IL-2	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery), reactivity not specified Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ	IL-2	Abl Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) with growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1) reactive) Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + SQ IL-2 (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF (no reactivity)	IL-2	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 ( IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) in patients with no reactivity Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells in culture	Apheresis	Peripheral blood mononuclear cells (PBMC) and/or tumor infiltrating lymphocytes (TIL) obtained by apheresis or lesion excision to be cloned and expanded in the lab.The patients underwent an apheresis and/or an excision of their tumor. They didn't receive any drugs.
Abl Cells IV + Cyclophosphamide 30 mg/kg	Abl cells	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x30mg/kg + Cells intravenous (IV) Abl cells intravenous (IV) = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + Cyclophosphamide 60 mg/kg	Abl cells	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+Low Dose IV IL-2 (Initial)	Abl cells	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (72,000 IU/kg q8h for a maximum of 15 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ	GCSF (Growth colony stimulating factor)	Abl Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) with growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1) reactive) Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + SQ IL-2 (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF (no reactivity)	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 ( IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) in patients with no reactivity Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF (no reactivity)	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 ( IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) in patients with no reactivity Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+High Dose IV IL-2 (Initial)	Abl cells	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD (prior cells IV on 6)	IL-2	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) Prior Cells IV + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD (prior cells IV on 6)	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) Prior Cells IV + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD (prior cells IV on 6)	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) Prior Cells IV + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD (prior cells IV on 6)	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) Prior Cells IV + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD IL-2	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD IL-2	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA+MTD IL-2 (MART-1 reactive)	Montanide ISA-51	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) + melanoma- associated antigen recognized by T cells (MART-1):26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days gp100 = gp100:209-217(210M) peptide - 1 mg in IFA SQ (in the subcutaneous tissue of each thigh) on the morning of the cell infusion, plus gp100:209-217(210M) peptide, 1 mg, in IFA injected into the subcutaneous tissue in two equal volumes, 1.0 mL for each injection, within 2cm of each other, in the thigh daily for five days starting on the morning of the cell infusion and then weekly for 3 more injections.
Abl Cells IA+MTD IL-2 (MART-1 reactive)	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) + melanoma- associated antigen recognized by T cells (MART-1):26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days gp100 = gp100:209-217(210M) peptide - 1 mg in IFA SQ (in the subcutaneous tissue of each thigh) on the morning of the cell infusion, plus gp100:209-217(210M) peptide, 1 mg, in IFA injected into the subcutaneous tissue in two equal volumes, 1.0 mL for each injection, within 2cm of each other, in the thigh daily for five days starting on the morning of the cell infusion and then weekly for 3 more injections.
Abl Cells IA+MTD IL-2 (MART-1 reactive)	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) + melanoma- associated antigen recognized by T cells (MART-1):26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days gp100 = gp100:209-217(210M) peptide - 1 mg in IFA SQ (in the subcutaneous tissue of each thigh) on the morning of the cell infusion, plus gp100:209-217(210M) peptide, 1 mg, in IFA injected into the subcutaneous tissue in two equal volumes, 1.0 mL for each injection, within 2cm of each other, in the thigh daily for five days starting on the morning of the cell infusion and then weekly for 3 more injections.
Abl Cells IV + MTD IL-2 no GCSF	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without growth colony stimulating factor (G-CSF) (to determine if G-CSF has harmful effects when adoptively transferring lymphocytes following a nonmyeloablative chemotherapy regimen) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2 no GCSF	Abl cells	Abl Cells intravenous (IV) + maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF)(gp100 reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + gp100:209-217(210M) 1mg/day (2-8 days) in patients with gp100 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2 no GCSF	Fludarabine	Abl Cells intravenous (IV) + maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF)(gp100 reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + gp100:209-217(210M) 1mg/day (2-8 days) in patients with gp100 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2 no GCSF	Cyclophosphamide	Abl Cells intravenous (IV) + maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF)(gp100 reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + gp100:209-217(210M) 1mg/day (2-8 days) in patients with gp100 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2	Abl cells	Abl Cells intravenous (IV)+ maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1)reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF	Abl cells	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery), reactivity not specified Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF	GCSF (Growth colony stimulating factor)	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery), reactivity not specified Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ	Abl cells	Abl Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) with growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1) reactive) Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + SQ IL-2 (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + Cyclophosphamide 30 mg/kg	Fludarabine	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x30mg/kg + Cells intravenous (IV) Abl cells intravenous (IV) = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + Cyclophosphamide 60 mg/kg	Cyclophosphamide	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + Cyclophosphamide 30 mg/kg	Cyclophosphamide	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x30mg/kg + Cells intravenous (IV) Abl cells intravenous (IV) = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + Cyclophosphamide 60 mg/kg	Fludarabine	Phase 1 Cyclophosphamide Dose Escalation: Fludarabine 5x25mg/m2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+Low Dose IV IL-2 (Initial)	Cyclophosphamide	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (72,000 IU/kg q8h for a maximum of 15 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+Low Dose IV IL-2 (Initial)	Fludarabine	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (72,000 IU/kg q8h for a maximum of 15 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+High Dose IV IL-2 (Initial)	IL-2	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+High Dose IV IL-2 (Initial)	Fludarabine	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+High Dose IV IL-2 (Initial)	Cyclophosphamide	Phase 1 interleukin-2 (IL-2) Dose Escalation: Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV IL-2 (720,000 IU/kg q8h for a maximum of 12 doses) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD IL-2	IL-2	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD (prior cells IV on 6)	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) Prior Cells IV + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD IL-2	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA + MTD IL-2	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IA+MTD IL-2 (MART-1 reactive)	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) + melanoma- associated antigen recognized by T cells (MART-1):26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days gp100 = gp100:209-217(210M) peptide - 1 mg in IFA SQ (in the subcutaneous tissue of each thigh) on the morning of the cell infusion, plus gp100:209-217(210M) peptide, 1 mg, in IFA injected into the subcutaneous tissue in two equal volumes, 1.0 mL for each injection, within 2cm of each other, in the thigh daily for five days starting on the morning of the cell infusion and then weekly for 3 more injections.
Abl Cells IA+MTD IL-2 (MART-1 reactive)	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intra-arterial (IA) + intravenous (IV) interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) + growth colony stimulating factor (G-CSF) + melanoma- associated antigen recognized by T cells (MART-1):26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IA = Lymphocytes 10\^9-10\^11 IA over 30 minutes on day 0, repeated in 14 to 21 days gp100 = gp100:209-217(210M) peptide - 1 mg in IFA SQ (in the subcutaneous tissue of each thigh) on the morning of the cell infusion, plus gp100:209-217(210M) peptide, 1 mg, in IFA injected into the subcutaneous tissue in two equal volumes, 1.0 mL for each injection, within 2cm of each other, in the thigh daily for five days starting on the morning of the cell infusion and then weekly for 3 more injections.
Abl Cells IV + MTD IL-2 no GCSF	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without growth colony stimulating factor (G-CSF) (to determine if G-CSF has harmful effects when adoptively transferring lymphocytes following a nonmyeloablative chemotherapy regimen) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + MTD IL-2 no GCSF	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without growth colony stimulating factor (G-CSF) (to determine if G-CSF has harmful effects when adoptively transferring lymphocytes following a nonmyeloablative chemotherapy regimen) Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2	Fludarabine	Abl Cells intravenous (IV)+ maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1)reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV+MTD IL-2	Cyclophosphamide	Abl Cells intravenous (IV)+ maximum tolerated dose (MTD) interleukin-2 (IL-2) no growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1)reactive). Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + IV interleukin-2 (IL-2) (720,000 IU/kg q8h for a maximum of 12 doses) without G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery), reactivity not specified Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) (to shorten time to neutrophil recovery), reactivity not specified Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ	Fludarabine	Abl Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) with growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1) reactive) Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + SQ IL-2 (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ	Cyclophosphamide	Abl Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 (IL-2) with growth colony stimulating factor (GCSF) (melanoma-associated antigen recognized by T cells (MART-1) reactive) Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells IV + SQ IL-2 (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + G-CSF + MART-1:26-35(27L) Peptide 1mg/day (5-8 days) in patients with MART-1 reactive cells Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF (no reactivity)	Fludarabine	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 ( IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) in patients with no reactivity Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days
Abl Cells IV + SQ IL-2 with GCSF (no reactivity)	Cyclophosphamide	Phase 2 Fludarabine 5x25mg/m\^2 + Cyclophosphamide 2x60mg/kg + Cells intravenous (IV) + subcutaneous (SQ) interleukin-2 ( IL-2) (125,000 IU/kg/dose for 5 days for six weeks with 2 days rest per week) + growth colony stimulating factor (G-CSF) in patients with no reactivity Abl cells IV = Lymphocytes 10\^9-10\^11 IV over 30 minutes on day 0, repeated in 14 to 21 days

Primary Outcome Measures

Name	Time	Method
Clinical Response	Every three to four weeks after the treatment, for up to 5 years.	Complete response (CR) is defined as the disappearance of all clinical evidence of disease. Partial response (PR) is a 50% or greater decrease in the sum of the products of perpendicular diameters of all measurable lesions for at least one month. No new lesions may appear, and none may increase. Minor response (MR) is a 25-49% decrease in the sum of the products of the perpendicular diameters of all measurable lesions. Appearance of new lesions following a PR or CR are considered relapses. Patients with progressive disease (PD) and no evidence of stable disease will be taken off study after receiving IL-2.

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Adverse Events	10.5 months	Here is the number of participants with adverse events. For a detailed list of adverse events see the adverse event module.