Zoledronic Acid and Combination Chemotherapy in Treating Patients With Newly Diagnosed Metastatic Osteosarcoma

DISEASE CHARACTERISTICS:

   - Biopsy-proven high-grade osteosarcoma within the past 6 weeks

      - Newly diagnosed disease

      - Metastatic disease

   - Resectable disease OR expected to become resectable after initial chemotherapy

   - Disease has arisen outside of areas of Paget's disease

PATIENT CHARACTERISTICS:

   - ECOG performance status (PS) 0-2 OR Karnofsky PS 50-100% (for patients > 16 years of
   age) OR Lansky PS 50-100% (for patients ≤ 16 years of age)

   - Creatinine clearance or radioisotope glomerular filtration rate ≥ 70 mL/min OR maximum
   serum creatinine based on age/gender as follows:

      - 0.4 mg/dL (for patients 1 to 5 months of age)

      - 0.5 mg/dL (for patients 6 to 11 months of age)

      - 0.6 mg/dL (for patients 1 year of age)

      - 0.8 mg/dL (for patients 2 to 5 years of age)

      - 1 mg/dL (for patients 6 to 9 years of age)

      - 1.2 mg/dL (for patients 10 to 12 years of age)

      - 1.5 mg/dL (males) or 1.4 mg/dL (females) (for patients 13 to 15 years of age)

      - 1.7 mg/dL (males) or 1.4 mg/dL (females) (for patients ≥ 16 years of age)

   - Total bilirubin ≤ 1.5 times upper limit of normal (ULN) for age

   - AST or ALT < 2.5 times ULN for age

   - Shortening fraction ≥ 28% by echocardiogram OR ejection fraction ≥ 50% by radionuclide
   angiogram

   - ANC ≥ 1,000/mm³

   - Platelet count ≥ 100,000/mm³ (transfusion independent)

   - Hemoglobin ≥ 10 g/dL (RBC transfusion allowed)

   - Not pregnant or nursing

   - Negative pregnancy test

   - Fertile patients must use contraception

   - No known HIV infection

   - No history of pericarditis, myocarditis, symptomatic arrhythmia, or conduction
   disturbances

PRIOR CONCURRENT THERAPY:

   - No prior chemotherapy or radiotherapy

   - No other concurrent anticancer chemotherapy

   - No concurrent immunomodulating agents

   - Steroids for anti-emetic allowed