Tanespimycin in Treating Patients With Stage III-IV Melanoma

Inclusion Criteria:

• Histologically or cytologically confirmed melanoma

  • Stage III or IV disease
• No primary melanoma of the choroid or mucosa

• Measurable disease

  • At least 1 unidimensionally measurable lesion >= 20 mm by conventional techniques OR >= 10 mm by spiral CT scan

• Tumor amenable to biopsy (for the first 10 patients in each stratum only)

  • Patients must have measurable disease in addition to the tumor(s) to be biopsied

• No brain or epidural metastases

  • Completely resected solitary brain metastases allowed provided patient has been free of CNS metastases for >= 6 months
• Performance status - Karnofsky 60-100%
• Performance status - ECOG 0-2
• More than 3 months
• Absolute neutrophil count >= 1,500/mm^3
• Platelet count >= 100,000/mm^3
• WBC >= 3,000/mm^3
• AST and ALT =< 2.5 times upper limit of normal
• Creatinine normal
• No symptomatic congestive heart failure
• No unstable angina pectoris
• No cardiac arrhythmia
• No history of myocardial infarction
• No history of prolonged QTc interval
• No active ischemic heart disease within the past 12 months
• No uncontrolled dysrhythmia or dysrhythmias requiring medication
• No congenital prolonged QT syndrome
• No left bundle branch block
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No prior allergic reaction attributed to compounds of similar chemical or biological composition to 17-N-allylamino-17-demethoxygeldanamycin (17-AAG)
• No prior serious allergic reaction to eggs
• No other uncontrolled illness
• No active or ongoing infection requiring systemic antimicrobial treatment
• No psychiatric illness or social situation that would preclude study compliance

• No more than 1 prior chemotherapy regimen for metastatic melanoma

  • Prior vaccines, cytokines, or interferon alfa is not considered prior therapy unless administered with a chemotherapy drug
• More than 4 weeks since prior chemotherapy (6 weeks for nitrosoureas or mitomycin) and recovered
• Prior radiotherapy dose =< 3,000 cGy to fields including substantial marrow
• More than 4 weeks since prior radiotherapy and recovered
• No prior radiotherapy field that included the heart (e.g., mantle)
• No concurrent combination antiretroviral therapy for HIV-positive patients
• No concurrent medications that may prolong the QTc interval
• No other concurrent anticancer therapy
• No other concurrent investigational agents

• No concurrent treatment with any of the following medications or herbal remedies:

  • Inhibitors of CYP3A4:

    • Fluconazole
    • Itraconazole
    • Ketoconazole
    • Macrolide antibiotics (azithromycin, clarithromycin, erythromycin, or troleandomycin)
    • Midazolam
    • Nifedipine
    • Verapamil
    • Diltiazem
    • Terfenadine
    • Cyclosporine
    • Cisapride

  • Inducers of CYP3A4:

    • Carbamazepine
    • Phenobarbital
    • Phenytoin
    • Rifampin

  • Herbal extracts and tinctures with CYP3A4 inhibitory activity:

    • Hydrastis canadensis (goldenseal)
    • Hypericum perforatum (St. John's wort)
    • Uncaria tomentosa (cat's claw)
    • Echinacea angustifolia roots
    • Trifolium pratense (wild cherry)
    • Matricaria chamomilla (chamomile)
    • Glycyrrhiza glabra (licorice)
    • Dillapiol
    • Hypericin
    • Naringin
• No other concurrent herbal extracts