Patient description: A 65 yo male with no significant history of cardiovascular disease presents to the emergency room with acute onset of shortness of breath, tachypnea, and left-sided chest pain that worsens with inspiration. Of note, he underwent a right total hip replacement two weeks prior to presentation and was unable to begin physical therapy and rehabilitation for several days following the surgery due to poor pain management. Relevant physical exam findings include a respiratory rate of 35 and right calf pain.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Malignant Pleural Mesothelioma Subjects must have histologically confirmed MPM (epithelial or biphasic) Subjects must have completed standard first line therapy with a platinum-based double regimen and had PD or they must have chosen not to pursue primary standard of care therapy ECOG performance status 0 to 1 Age greater than 18 years Life expectancy > 4 months At least 2 weeks since prior and no other concurrent chemotherapy, radiotherapy, or immunotherapy (e.g., interferons, tumor necrosis factor, interleukins, or monoclonal antibodies). In addition, the patient must have fully recovered from any adverse events related to these agents More than 4 weeks since prior and no other concurrent investigational agents Subjects must have measurable disease as defined by accepted MPM measurement techniques (modified criteria) Blood coagulation parameters: PT such that international normalized ratio (INR) is < 1.5 (or an in-range INR, usually between 2 and 3, if a subject is on a stable dose of therapeutic warfarin for management of venous thrombosis including pulmonary thromboembolus) and a PTT < 1.2 times the upper limit of normal Subjects must have adequate venous peripheral access for apheresis. Patients must also have adequate venous access for subsequent modified CIR T-cell administration which can be done through a central venous access (e.g. port of systemic chemotherapy)  Previously treated with any investigation therapy within 1 month prior to screening Sacromatoid MPM histology which does not express mesothelin Prior invasive malignancies unless surgically and medically cured without evidence of recurrent disease for 5 years with the exception of non-melanoma skin cancer, prostate cancer with PSA level < 1.0 Prior hematologic malignancy with bone marrow transplantation or immune modifying therapy within the past 4 weeks with the exception of thyroid replacement Use of immunosuppressive drugs with 4 weeks prior to study entry, or anticipated use of immunosuppressive agents Any clinically -significant pericardial effusion, CHF (NY Heart Association Grade II-IV ), or cardiovascular condition Any clinically -significant pleural effusion or ascites that cannot be drained with standard approaches or with pre-enrollment in dwelling drainage device placement Forced vital capacity < 50% predicted, DLCO < 40% predicted Underlying lung disease requiring supplemental oxygen therapy Have a recognized immunodeficiency disease including cellular immunodeficiency, hypogammaglobulinemia, or dysgammaglobulinemia; patients who have acquired hereditary, congenital immunodeficiency