Melphalan With or Without Tumor Necrosis Factor in Treating Patients With Locally Advanced Melanoma of the Arm or Leg

You may be eligible if

• Histologically proven locally advanced melanoma of an extremity
• * One or more evaluable in-transit metastases
• * All disease within the perfusion field of the extremity (with no local resection options short of amputation)
• * Disease outside of perfusion field (with no local resection options short of amputation) if all the following are true:
• * High tumor burden (more than 10 lesions or any single lesion greater than 3 cm)
• * Presence of pain, edema, skin breakdown, or decreased mobility
• * Greater than 80% of known tumor is within extremity perfusion field
• * Life expectancy more than 6 months
• * No brain metastases
• At least 1 bidimensionally measurable lesion
• Patients who received prior prophylactic isolated limb perfusion (ILP) must have 1 of the following:
• * Disease-free interval for at least 6 months after prior ILP with melphalan
• * Disease-free interval for at least 3 months after prior ILP with an agent other than melphalan
• Patients who received prior therapeutic ILP must have 1 of the following:
• * Partial response of at least 3 months duration after prior ILP with melphalan
• * Stable response or disease progression after ILP without melphalan (performed at least 3 months prior to study)
• Performance status - ECOG 0-2
• Performance status - Zubrod 0-2
• See Disease Characteristics
• Platelet count at least 100,000/mm\^3
• WBC greater than 2,500/mm\^3
• Hemoglobin greater than 9 g/dL
• Bilirubin less than 1.25 times ULN
• AST and ALT less than 2 times ULN
• Alkaline phosphatase less than 2 times ULN
• Coagulation studies normal or within 1 second of upper limit of normal (ULN)
• Creatinine less than 1.5 mg/dL
• Creatinine clearance greater than 50 mL/min
• Calcium less than 12 mg/dL
• No severe peripheral vascular disease (claudication or other ischemic peripheral vascular disease \[e.g., venous thrombosis or occlusive peripheral arterial disease\])
• No New York Heart Association class II-IV heart disease (congestive heart failure)
• No uncontrolled or life-threatening cardiac arrhythmia
• No myocardial infarction within the past year
• No unstable angina
• No symptomatic cerebral or carotid artery disease
• No pulmonary embolism within the past year
• Other prior malignancy allowed if completed curative therapy, disease-free for at least 5 years, and at low risk for recurrence
• No active peptic ulcer disease within the past year
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No known melphalan hypersensitivity
• No known hypersensitivity to any component of tumor necrosis factor alpha formulation
• No contraindications to ionotropic agents (e.g., dopamine or neosynephrine)
• No concurrent infections uncontrolled with antibiotics
• HIV negative
• At least 1 month since prior biologic therapy
• See Disease Characteristics
• At least 1 month since prior chemotherapy
• At least 4 months since prior isolated limb perfusion
• At least 1 month since prior radiotherapy
• See Disease Characteristics
• At least 12 months since prior coronary artery surgery or angioplasty