Combination Chemotherapy With or Without Interleukin-2 and Interferon Alfa in Treating Patients With Metastatic Melanoma

DISEASE CHARACTERISTICS:

• Histologically confirmed surgically incurable metastatic malignant melanoma
• Measurable disease
• No active brain metastases or edema
• No leptomeningeal disease
• No ocular melanoma

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• ECOG 0-1

Life expectancy:

• Not specified

Hematopoietic:

• Absolute neutrophil count at least 1,500/mm^3
• Platelet count at least 100,000/mm^3
• Hemoglobin at least 9 g/dL

Hepatic:

• Bilirubin no greater than 1.5 mg/dL
• SGOT less than 3 times the upper limit of normal unless due to liver metastases

Renal:

• Creatinine less than 1.5 mg/dL OR
• Creatinine clearance at least 75 mL/min

Cardiovascular:

• No congestive heart failure
• No symptoms of coronary artery disease
• No serious cardiac arrhythmias
• No prior myocardial infarction on EKG

• Normal cardiac stress test required for the following:

  • Over 50 years of age
  • Abnormal EKG
  • Prior history of cardiac disease

Pulmonary:

• No symptomatic pulmonary disease
• FEV1 greater than 2.0 L OR at least 75% predicted if over 50 years of age or with history of pulmonary symptoms

Other:

• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No significant infection
• HIV negative
• No other prior malignancy within the past 5 years except basal cell or squamous cell skin cancer or carcinoma in situ of the cervix
• No organ allografts
• No significant disease other than malignancy
• No seizure disorder

PRIOR CONCURRENT THERAPY:

Biologic therapy:

• No prior interleukin-2 therapy for metastatic disease
• At least 4 weeks since prior vaccine therapy
• At least 4 weeks since prior adjuvant immunotherapy

Chemotherapy:

• No prior chemotherapy for disease

Endocrine therapy:

• No concurrent corticosteroids

Radiotherapy:

• No prior radiation therapy to measurable disease site unless disease is clearly progressive
• At least 4 weeks since prior radiation therapy for local control or palliation and recovered

Surgery:

• Recovered from prior surgery

Other:

• No prior systemic therapy for metastatic disease
• At least 3 months since definitive therapy for brain metastases