| Exclusion Criteria: | 1) More than one prior chemotherapy regimen. Prior doxorubicin treatment is permitted. However patient's with >250 mg/m2 cumulative dosage are excluded.
2) Prior radioisotope treatment consisting of strontium-89 or samarium-153.
3) Zoledronic acid treatment for more than 3 months duration prior to registration. Other bisphosphonate treatments are permitted.
4) Corrected serum calcium level less than 8 mg/dL.
5) Patients may not be receiving any other investigational agents.
6) Patients with known brain metastases should be excluded from this clinical trial because of their poor prognosis and because they often develop progressive neurologic dysfunction that would confound the evaluation of neurologic and other adverse events.
7) History of allergic reactions attributed to compounds of similar chemical or biologic composition to zoledronic acid or other agents used in the study
8) Patients with the following atypical presentations should have a biopsy: those with small cell carcinoma, purely lytic bone metastases, or bulky (i.e. 5 cm) visceral or nodal disease in the absence of bone involvement are not eligible.
9) Symptomatic bulky lymphadenopathy causing scrotal or pedal edema or significant local invasive disease in bladder invasion.
10) History of other malignancies other than nonmelanoma skin cancer, unless in complete remission and off therapy for that disease for at least 5 years.
11) Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, history of congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
12) Because patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy, HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with strontium-89 or other agents administered during the study. Appropriate studies will be undertaken in patients receiving combination anti-retroviral therapy when indicated.
13) Evidence or suspicion of myelodysplastic syndrome by CBC must be confirmed by bone marrow biopsy.
14) Untreated symptomatic spinal cord compressions. |