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The mesenchymal, clear cell, and dedifferentiated chondrosarcoma subtypes are extremely rare, together constituting 10% to 15% of all chondrosarcomas. Their poor prognosis and lack of efficacious treatment emphasizes the need to elucidate the pathways playing a pivotal role in these tumors. We constructed tissue microarrays containing 42 dedifferentiated, 23 clear cell, and 23 mesenchymal chondrosarcomas and performed immunohistochemistry to study the expression of growth plate-signaling molecules and molecules shown to be involved in conventional chondrosarcoma. We observed high expression of SOX-9 and FGFR-3, as well as aberrant cellular localization of heparan sulfate proteoglycans, in all subtypes. TGFβ signaling through p-SMAD2 and PAI-1 was highly active in all chondrosarcoma subtypes, which suggests that TGFβ inhibitors as a possible therapeutic strategy in rare chondrosarcoma subtypes. As in conventional chondrosarcoma, antiapoptotic proteins (Bcl-2, and/or Bcl-xl) were highly expressed in all subtypes. Inhibition with the BH-3 mimetic ABT-737 rendered dedifferentiated chondrosarcoma cell lines sensitive to doxorubicin or cisplatin. Our data indicate that antiapoptotic proteins may play an important role in chemoresistance, suggesting a promising role for targeting Bcl-2 family members in chondrosarcoma treatment, irrespective of the subtype.

Original publication




Journal article


Am j pathol

Publication Date





1347 - 1356


Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Cell Dedifferentiation, Chondrosarcoma, Mesenchymal, Drug Resistance, Neoplasm, Female, Humans, Immunohistochemistry, Male, Middle Aged, Molecular Targeted Therapy, Neoplasm Proteins, Paraffin Embedding, Proto-Oncogene Proteins c-bcl-2, Sarcoma, Clear Cell, Signal Transduction, Tissue Fixation, Transforming Growth Factor beta, Young Adult