How Is Chondrosarcoma Treated?

Treatment options for chondrosarcoma are limited and primarily include surgery and other procedures, followed by physical therapy. However, new research is showing that targeted therapies may also be effective.

This article discusses the treatment options for chondrosarcoma and presents current research regarding targeted therapies.

Surgery

Surgery is the first-line treatment option for people with chondrosarcoma because other traditional cancer therapies, like chemotherapy, tend to be ineffective against these types of tumors.

The types of surgeries used include:

• Wide local excision: A wide local excision is a surgical procedure that removes the tissue affected by the cancer.
• Intralesional excision with curettage: This process involves the use of a special tool known as a curette to remove the affected tissue by scraping it. Curettage often involves the use of cryotherapy (extremely cold temperatures), bone cement, or other substance applications.

In some cases, the aforementioned surgeries will include other procedures to help restore or retain the integrity of the bone affected, such as:

• Bone grafting: Bone grafting uses bone from another area of the body to help restore or rebuild any bone lost during surgical removal of chondrosarcoma.
• Bone cementation: Bone cementation involves the use of bone cement, a type of cement that can be used in the place of bone to help anchor joints to one another. The use of bone cement after surgery has been shown to reduce the risk of cancer recurrence.
• Allograft: An allograft is the reconstruction of the affected area using tissue or cartilage from another person.
• Megaprosthesis: Megaprosthesis is a type of reconstruction that uses prosthetic devices that are surgically implanted into areas of the affected bone. They usually are used when a section of the long bones, such as the legs bones, have to be removed because of chondrosarcoma.

Physical Therapy

Physical therapy is a treatment option used following surgery to help a person regain mobility, strengthen the affected area, and essentially return to normal following the surgical procedure.

New Techniques Being Explored

While there are limited treatments available for chondrosarcoma besides surgery, new research has begun to shed light on possible targeted therapies that may be effective.

Angiogenesis Inhibitors

Angiogenesis inhibitors are used to slow the growth of new blood vessels. In terms of chondrosarcoma, the therapy may help because of its correlation with vascular endothelial growth factor (VEGF), which is a protein that helps form blood vessels.

Using angiogenesis inhibitors to address chondrosarcoma is done by changing the way VEGF stimulates the growth and movement of cells that form the inner lining of blood vessels. By doing so, the response of the endothelial cells is reduced, and thus, the molecules of VEGF found in chondrosarcoma are also reduced.

Cyclin-Dependent Kinase Inhibitors

A cyclin-dependent kinase inhibitor is a type of protein that hinders the action of an enzyme known as cyclin-dependent kinase. These types of proteins help to regulate cell cycles. In some cases, these enzymes can help speed cancer growth by aiding in cell division.

Currently, this type of treatment is approved for use in breast cancer and has shown promise. Current studies using cyclin-dependent kinase inhibitors for chondrosarcoma are showing promise in terms of them being a viable treatment option. Still, more research is needed.

mTOR Inhibitors

Mechanistic target of rapamycin (mTOR) inhibitors hinder the action of rapamycin, a protein that helps with cell survival within the body, including cancer cells. When rapamycin is inhibited, tumor progression can be halted.

Other Inhibitors

Other types of inhibitors can also treat chondrosarcoma:

• IDH inhibitors: IDH1 and IDH2 genes are mutated in approximately 50% of chondrosarcoma, A study using an IDH inhibitor called Ivosidenib in patients with chondrosarcoma bearing IDH1 mutations showed promising results.
• Osteoclast inhibitors: Osteoclast inhibitors like Zolendonic acid are commonly used in chondrosarcoma to prevent fractures.

Immunotherapy

Immunotherapy is a type of treatment option that relies on stimulating the action of the body’s own immune system to attack and kill cancer cells. It has been used successfully to treat a variety of different cancers such as metastatic melanoma (skin cancer that has spread elsewhere in the body), lung cancer, breast cancer, and renal cell carcinoma (kidney cancer).

In terms of chondrosarcoma, the research is scarce. The response to immunotherapy in chondrosarcoma is anecdotal, but one clinical study reported that one in four patients responded favorably to an immunotherapy known as nivolumab.

Summary

Chondrosarcoma is a type of bone cancer that primarily affects the cartilage and end area of bones. Treating the cancer can be difficult because it is highly resistant to chemotherapy and radiation. Because of this fact, the first-line therapy option is surgery to remove the tumor.

In some cases, metastatic cases will be addressed using radiation or chemotherapy, but other forms of treatment may be better suited. After surgery, physical therapy may be used to help restore mobility and strengthen the area. New treatments, such as immunotherapy and specific protein inhibition treatments, are on the horizon.

A Word From Verywell

Being diagnosed with chondrosarcoma can be both overwhelming and frightening. Knowing you may have to undergo surgery to remove the cancer is also scary. Fortunately, surgery typically removes the cancer-ridden area effectively, especially if it was caught early enough and remains localized to one area. Be sure to review the procedure with your oncologist or surgeon beforehand so you feel fully prepared.