A PHASE II TRIAL OF A VACCINE COMBINING MULTIPLE CLASS I PEPTIDES WITH MONTANIDE ISA 51 OR ISA 51 VG AND CpG ADJUVANT 7909 FOR PATIENTS WITH RESECTED STAGES IIC/III AND IV MELANOMA

Inclusion Criteria:

- Stages IIC, III and IV cutaneous, or mucosal melanoma or stages III/IV ocular
melanoma that have been completely resected; those rendered disease-free by radiation
or systemic chemotherapy and/or immune therapy will also be eligible; patients must
be entered within 12 months of disease-free status

- Patients must be positive for at least one of human leukocyte antigen (HLA) A1,
A3/A11 typed by a standard deoxyribonucleic acid (DNA)-polymerase chain reaction
(PCR) assay, and HLA-B44 status must be known; patients who are B44 positive but do
not express A1, A3 or A11 are not eligible for this trial

- Tumor tissue must be available for analysis of gp100 and tyrosinase expression by
immunohistochemistry; positive staining for at least one antigen will be an
eligibility criteria for this trial

- Serum creatinine of 2.0 mg/dl or less

- Total bilirubin of 2.0 mg/dl or less

- Serum glutamic oxaloacetic transaminase (SGOT)/serum glutamate pyruvate transaminase
(SGPT) of 2.5 X institutional norm or less

- Total white blood cell (WBC) of 3,000 or more

- At least 1500 granulocytes

- Hemoglobin of 9.0 gm/dl

- Platelet count of 100,000 per cu mm

- Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1

- Patients will be eligible for this trial if they have failed alpha-interferon, if it
is felt to be contraindicated due to a pre-existing medical or psychiatric condition
or if they have refused treatment with it

- Ability to read, understand and willingness to sign an institutional review board
(IRB)-approved informed consent

Exclusion Criteria:

- Who are undergoing or have undergone in the past month any other therapy for their
cancer, including radiation therapy and adjuvant therapy; six weeks must have elapsed
for nitrosoureas

- Have major systemic infections like pneumonia or sepsis, coagulation or bleeding
disorders, or other major medical illnesses of the gastrointestinal, cardiovascular
or respiratory systems

- Who require steroid therapy or have been treated with steroids within 4 weeks of
starting the trial

- Who are pregnant or lactating, since the risk of autoimmune reactivity to tyrosinase
or gp100 is felt to present a risk to the fetus or a breast feeding infant

- Who are known to be positive for hepatitis B surface antigen (BsAg), Hepatitis C
antibody or human immunodeficiency virus (HIV) antibody; since cells removed for ex
vivo handling and tissue culture cannot be virus positive, and the effects of 7909
might be detrimental to HIV positive patients, patients positive for the above
viruses will not be treated on this trial

- Who have had a known allergic reaction to Montanide ISA 51 or ISA 51 VG

- Who have a prior history of uveitis, autoimmune inflammatory eye disease or other
autoimmune diseases other than vitiligo or controlled thyroiditis

- Who have had another malignancy within the last three years with the exception of
squamous or basal carcinoma of the skin or carcinoma in situ of the cervix that have
been treated with curative intent

- Who have previously received any of the peptides in the vaccine