Skip to main content
Top
Published in: Journal of Gastroenterology 5/2011

01-05-2011 | Original Article—Alimentary Tract

A quality control program for mutation detection in KIT and PDGFRA in gastrointestinal stromal tumours

Authors: Isabelle Hostein, Maria Debiec-Rychter, Sylvianne Olschwang, Pierre-Paul Bringuier, Louisa Toffolati, David Gonzalez, Sébastien Forget, Fabienne Escande, Lucyna Morzuch, Elena Tamborini, Nicolas Faur, Silvana Pilotti, Paolo Dei Tos, Jean-François Emile, Jean-Michel Coindre

Published in: Journal of Gastroenterology | Issue 5/2011

Login to get access

Abstract

Background

Although most gastrointestinal stromal tumours (GIST) carry oncogenic mutations in KIT exons 9, 11, 13 and 17, or in platelet-derived growth factor receptor alpha (PDGFRA) exons 12, 14 and 18, around 10% of GIST are free of these mutations. Genotyping and accurate detection of KIT/PDGFRA mutations in GIST are becoming increasingly useful for clinicians in the management of the disease.

Method

To evaluate and improve laboratory practice in GIST mutation detection, we developed a mutational screening quality control program. Eleven laboratories were enrolled in this program and 50 DNA samples were analysed, each of them by four different laboratories, giving 200 mutational reports.

Results

In total, eight mutations were not detected by at least one laboratory. One false positive result was reported in one sample. Thus, the mean global rate of error with clinical implication based on 200 reports was 4.5%. Concerning specific polymorphisms detection, the rate varied from 0 to 100%, depending on the laboratory. The way mutations were reported was very heterogeneous, and some errors were detected.

Conclusion

This study demonstrated that such a program was necessary for laboratories to improve the quality of the analysis, because an error rate of 4.5% may have clinical consequences for the patient.
Appendix
Available only for authorised users
Literature
1.
go back to reference Tomillo L, Terracciano LM. An update on molecular genetics of gastrointestinal stromal tumours. J Clin Pathol. 2006;59:557–63.CrossRef Tomillo L, Terracciano LM. An update on molecular genetics of gastrointestinal stromal tumours. J Clin Pathol. 2006;59:557–63.CrossRef
2.
go back to reference Hirota S, Nishida T, Isozaki K, Taniguchi M, Nakamura J, Okazaki T, Kitamura Y. Gain of function mutation at the extracellular domain of KIT in gastrointestinal stromal tumours. J Pathol. 2001;193:505–10.PubMedCrossRef Hirota S, Nishida T, Isozaki K, Taniguchi M, Nakamura J, Okazaki T, Kitamura Y. Gain of function mutation at the extracellular domain of KIT in gastrointestinal stromal tumours. J Pathol. 2001;193:505–10.PubMedCrossRef
3.
go back to reference Heinrich MC, Corless CL, Duensing A, MsGreevey L, Chen CJ, Joseph N, Singer S, Griffith DJ, Haley A, Town A, Demetri GD, Fletcher CDM, Fletcher JA. PDGFRA activating mutations in gastrointestinal stromal tumours. Science. 2003;299:708–10.PubMedCrossRef Heinrich MC, Corless CL, Duensing A, MsGreevey L, Chen CJ, Joseph N, Singer S, Griffith DJ, Haley A, Town A, Demetri GD, Fletcher CDM, Fletcher JA. PDGFRA activating mutations in gastrointestinal stromal tumours. Science. 2003;299:708–10.PubMedCrossRef
4.
go back to reference Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813–25.PubMedCrossRef Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813–25.PubMedCrossRef
5.
go back to reference Lasota J, Wasag B, Steigen SE, Limon J, Miettinen M. Improved detection of KIT exon 11 duplication in formalin-fixed, paraffin-embedded gastrointestinal stromal tumours. J Mol Diagn. 2007;9:89–94.PubMedCrossRef Lasota J, Wasag B, Steigen SE, Limon J, Miettinen M. Improved detection of KIT exon 11 duplication in formalin-fixed, paraffin-embedded gastrointestinal stromal tumours. J Mol Diagn. 2007;9:89–94.PubMedCrossRef
6.
go back to reference Corless CL, McGreevey L, Town A, Schroeder A, Bainbridge T, Harrel P, Fletcher JA, Heinrich MC. KIT gene deletions at the intron 10–exon 11 boundary in GI stromal tumours. J Mol Diagn. 2004;6:366–70.PubMedCrossRef Corless CL, McGreevey L, Town A, Schroeder A, Bainbridge T, Harrel P, Fletcher JA, Heinrich MC. KIT gene deletions at the intron 10–exon 11 boundary in GI stromal tumours. J Mol Diagn. 2004;6:366–70.PubMedCrossRef
7.
go back to reference Wasag B, Debiec-Rychter M, Pauwels P, Stul M, Vrabckx H, Oosterom AV, Hagemeijer A, Sciot R. Differential expression of KIT/PDGFRA mutant isoforms in epithelioid and mixed variants of gastrointestinal stromal tumours depends predominantly on the tumor site. Mod Pathol. 2004;17:889–94.PubMedCrossRef Wasag B, Debiec-Rychter M, Pauwels P, Stul M, Vrabckx H, Oosterom AV, Hagemeijer A, Sciot R. Differential expression of KIT/PDGFRA mutant isoforms in epithelioid and mixed variants of gastrointestinal stromal tumours depends predominantly on the tumor site. Mod Pathol. 2004;17:889–94.PubMedCrossRef
8.
go back to reference Chen LL, Holden JA, Choi H, Zhu J, Wu EF, Jones KA, Ward JH, Andbacka RH, Randall RL, Scaife CL, Hunt KK, Prieto VG, Raymond AK, Zhang W, Trent JC, Benjamin RS, Frazier ML. Evolution from heterozygous to homozygous KIT mutation in gastrointestinal stromal tumor correlates with the mechanism of mitotic nondisjunction and significant tumor progression. Mod Pathol. 2008;21:826–36.PubMedCrossRef Chen LL, Holden JA, Choi H, Zhu J, Wu EF, Jones KA, Ward JH, Andbacka RH, Randall RL, Scaife CL, Hunt KK, Prieto VG, Raymond AK, Zhang W, Trent JC, Benjamin RS, Frazier ML. Evolution from heterozygous to homozygous KIT mutation in gastrointestinal stromal tumor correlates with the mechanism of mitotic nondisjunction and significant tumor progression. Mod Pathol. 2008;21:826–36.PubMedCrossRef
9.
go back to reference Lasota J, Stachura J, Miettinen M. GISTs with PDGFRA exon 14 mutations represent subset of clinically favorable gastric tumours with epithelioid morphology. Lab Invest. 2006;86:94–100.PubMedCrossRef Lasota J, Stachura J, Miettinen M. GISTs with PDGFRA exon 14 mutations represent subset of clinically favorable gastric tumours with epithelioid morphology. Lab Invest. 2006;86:94–100.PubMedCrossRef
10.
go back to reference Lasota J, Dansonka-Mieszhowska A, Sobin LH, Miettenen M. A great majority of GISTs with PDGFRA mutations represent gastric tumours of low or no malignant potential. Lab Invest. 2004;84:874–83.PubMedCrossRef Lasota J, Dansonka-Mieszhowska A, Sobin LH, Miettenen M. A great majority of GISTs with PDGFRA mutations represent gastric tumours of low or no malignant potential. Lab Invest. 2004;84:874–83.PubMedCrossRef
11.
go back to reference Hostein I, Longy M, Gastaldello B, Geneste G, Coindre JM. Detection of a new mutation in KIT exon 9 in a gastrointestinal stromal tumour. Int J Cancer. 2006;118:2089–91.PubMedCrossRef Hostein I, Longy M, Gastaldello B, Geneste G, Coindre JM. Detection of a new mutation in KIT exon 9 in a gastrointestinal stromal tumour. Int J Cancer. 2006;118:2089–91.PubMedCrossRef
12.
go back to reference Mazzola P, Spitale A, Banfi S, Mazzucchelli L, Frattini M, Bordoni A. Epidemiology and molecular biology of gastrointestinal stromal tumours (GISTs): a population-based study in the South of Switzerland, 1999–2005. Histol Histopathol. 2008;23:1379–86.PubMed Mazzola P, Spitale A, Banfi S, Mazzucchelli L, Frattini M, Bordoni A. Epidemiology and molecular biology of gastrointestinal stromal tumours (GISTs): a population-based study in the South of Switzerland, 1999–2005. Histol Histopathol. 2008;23:1379–86.PubMed
13.
go back to reference Biasco G, Velo D, Angriman I, Astorino M, Baldan A, Baseggio M, Basso U, Battaglia G, Bertin M, Bertorelle R, Bocus P, Brosolo P, Bulzacchi A, Cannizzaro R, Da Dalt GF, Di Battista M, Errante D, Fedrigo M, Frustaci S, Lionetti I, Massani M, Mencarelli R, Montesco MC, Norberto L, Pantaleo MA, Pasquali C, Pastorelli D, Rossi CR, Ruffolo C, Salvagno L, Saponara MS, Vittadello F, Zaccaria F, Zovato S, Farinati F. Gastrointestinal stromal tumours: report of an audit and review of the literature. Eur J Cancer Prev. 2009;18:106–16.PubMedCrossRef Biasco G, Velo D, Angriman I, Astorino M, Baldan A, Baseggio M, Basso U, Battaglia G, Bertin M, Bertorelle R, Bocus P, Brosolo P, Bulzacchi A, Cannizzaro R, Da Dalt GF, Di Battista M, Errante D, Fedrigo M, Frustaci S, Lionetti I, Massani M, Mencarelli R, Montesco MC, Norberto L, Pantaleo MA, Pasquali C, Pastorelli D, Rossi CR, Ruffolo C, Salvagno L, Saponara MS, Vittadello F, Zaccaria F, Zovato S, Farinati F. Gastrointestinal stromal tumours: report of an audit and review of the literature. Eur J Cancer Prev. 2009;18:106–16.PubMedCrossRef
14.
go back to reference Conca E, Negri T, Gronchi A, Furnagalli E, Tamborini E, Pavan GM, Fermeglia M, Pierotti MA, Pricl S, Pilotti S. Activate and resist: L576P-KIT in GIST. Mol Cancer Ther. 2009;8:2491–5.PubMedCrossRef Conca E, Negri T, Gronchi A, Furnagalli E, Tamborini E, Pavan GM, Fermeglia M, Pierotti MA, Pricl S, Pilotti S. Activate and resist: L576P-KIT in GIST. Mol Cancer Ther. 2009;8:2491–5.PubMedCrossRef
15.
go back to reference Lasota J, Miettinen M. Clinical significance of oncogenic KIT and PDGFRA mutations in gastrointestinal stromal tumours. Histopathol. 2008;53:245–66.CrossRef Lasota J, Miettinen M. Clinical significance of oncogenic KIT and PDGFRA mutations in gastrointestinal stromal tumours. Histopathol. 2008;53:245–66.CrossRef
16.
go back to reference Chen LL, Trent JC, Wu EF, Fuller GN, Ramdas L, Zhang W, Raymond AK, Prieton VG, Oyedeji CO, Hunt KK, Pollock RE, Feig BW, Hayes KJ, Choi H, Macapinlac HA, Hittelman W, Velasco MA, Patel S, Burgess MA, Benjamin RS, Frazier ML. A missense mutation in KIT kinase domain 1 correlates with imatinib resistance in gastrointestinal stromal tumours. Cancer Res. 2004;64:5913–9.PubMedCrossRef Chen LL, Trent JC, Wu EF, Fuller GN, Ramdas L, Zhang W, Raymond AK, Prieton VG, Oyedeji CO, Hunt KK, Pollock RE, Feig BW, Hayes KJ, Choi H, Macapinlac HA, Hittelman W, Velasco MA, Patel S, Burgess MA, Benjamin RS, Frazier ML. A missense mutation in KIT kinase domain 1 correlates with imatinib resistance in gastrointestinal stromal tumours. Cancer Res. 2004;64:5913–9.PubMedCrossRef
17.
go back to reference Lasota J, Corless CL, Heinrich MC, Debiec-Rychter M, Sciot R, Wardelmann E, Merkelbach-Bruse S, Schildhaus HU, Steigen SE, Stachura J, Wozniak A, Antonescu C, Daum O, Martin J, Del Muro JG, Miettinen M. Clinicopathologic profile of gastrointestinal stromal tumours (GISTs) with primary KIT exon 13 or exon 17 mutations: a multicenter study on 54 cases. Mod Pathol. 2008;21:476–84.PubMedCrossRef Lasota J, Corless CL, Heinrich MC, Debiec-Rychter M, Sciot R, Wardelmann E, Merkelbach-Bruse S, Schildhaus HU, Steigen SE, Stachura J, Wozniak A, Antonescu C, Daum O, Martin J, Del Muro JG, Miettinen M. Clinicopathologic profile of gastrointestinal stromal tumours (GISTs) with primary KIT exon 13 or exon 17 mutations: a multicenter study on 54 cases. Mod Pathol. 2008;21:476–84.PubMedCrossRef
18.
go back to reference Wardelmann E, Thomas N, Merkelbach-Bruse S, Pauls K, Speidel N, Buttner R, Bihl H, Leutner CC, Heinicke T, Hohenberger P. Acquired resistance to imatinib in gastrointestinal stromal tumours caused by multiple KIT mutations. Lancet Oncol. 2005;6:249–51.PubMedCrossRef Wardelmann E, Thomas N, Merkelbach-Bruse S, Pauls K, Speidel N, Buttner R, Bihl H, Leutner CC, Heinicke T, Hohenberger P. Acquired resistance to imatinib in gastrointestinal stromal tumours caused by multiple KIT mutations. Lancet Oncol. 2005;6:249–51.PubMedCrossRef
19.
go back to reference Antonescu CR, Besmer P, Guo T, Arkun K, Horn G, Koryotowski B, Leversha MA, Jeffrey PD, Desantis D, Singer S, Brennan MF, Maki RG, DeMatteo RP. Acquired resistance to imatinib in gastrointestinal stromal tumor occurs through secondary gene mutation. Clin Cancer Res. 2005;11:4182–90.PubMedCrossRef Antonescu CR, Besmer P, Guo T, Arkun K, Horn G, Koryotowski B, Leversha MA, Jeffrey PD, Desantis D, Singer S, Brennan MF, Maki RG, DeMatteo RP. Acquired resistance to imatinib in gastrointestinal stromal tumor occurs through secondary gene mutation. Clin Cancer Res. 2005;11:4182–90.PubMedCrossRef
20.
go back to reference Debiec-Rychter M, Cools J, Dumez H, Sciot R, Stul M, Mentens N, Vranckx H, Wasag B, Prenen H, Roesel J, Hagemeijer A, Van Oosterom A, Marynen P. Mechanisms of resistance to imatinib mesylate in gastrointestinal stromal tumours and activity of the PKC412 inhibitor against imatinib resistant mutants. Gastroenterology. 2005;128:270–9.PubMedCrossRef Debiec-Rychter M, Cools J, Dumez H, Sciot R, Stul M, Mentens N, Vranckx H, Wasag B, Prenen H, Roesel J, Hagemeijer A, Van Oosterom A, Marynen P. Mechanisms of resistance to imatinib mesylate in gastrointestinal stromal tumours and activity of the PKC412 inhibitor against imatinib resistant mutants. Gastroenterology. 2005;128:270–9.PubMedCrossRef
21.
go back to reference Lasota J, vel Dobosz AJ, Wasag B, Wozniak A, Kraszewska E, Michej W, Ptasynski K, Rutkowski P, Sarlomo-Rikala M, Steigen SE, Schneider-Stock R, Stachura J, Chosia M, Ogun G, Ruka W, Siedlecki JA, Miettinen M. Presence of homozygous KIT exon 11 mutations is strongly associated with malignant behavior in gastrointestinal stromal tumours. Lab Invest. 2007;87:1029–41.PubMedCrossRef Lasota J, vel Dobosz AJ, Wasag B, Wozniak A, Kraszewska E, Michej W, Ptasynski K, Rutkowski P, Sarlomo-Rikala M, Steigen SE, Schneider-Stock R, Stachura J, Chosia M, Ogun G, Ruka W, Siedlecki JA, Miettinen M. Presence of homozygous KIT exon 11 mutations is strongly associated with malignant behavior in gastrointestinal stromal tumours. Lab Invest. 2007;87:1029–41.PubMedCrossRef
22.
go back to reference Emile JF, Bachet JB, Tabone-Eglinger S, Terrier P, Vignault JM. GIST with homozygous KIT exon 11 mutations. Lab Invest. 2008;88:456–7.PubMedCrossRef Emile JF, Bachet JB, Tabone-Eglinger S, Terrier P, Vignault JM. GIST with homozygous KIT exon 11 mutations. Lab Invest. 2008;88:456–7.PubMedCrossRef
23.
go back to reference Gastrointestinal Stromal Tumor Meta-Analysis Group (MetaGIST). Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors: a meta-analysis of 1,640 patients. J Clin Oncol. 2010;28:1247–53.CrossRef Gastrointestinal Stromal Tumor Meta-Analysis Group (MetaGIST). Comparison of two doses of imatinib for the treatment of unresectable or metastatic gastrointestinal stromal tumors: a meta-analysis of 1,640 patients. J Clin Oncol. 2010;28:1247–53.CrossRef
24.
go back to reference Heinrich MC, Owzar K, Corless CL, Hollis D, Borden EC, Fletcher CD, Ryan CW, von Mehren M, Blanke CD, Rankin C, Benjamin RS, Bramwell VH, Demetri GD, Bertagnolli MM, Fletcher JA. Correlation of kinase genotype and clinical outcome in the North American Intergroup Phase III Trial of imatinib mesylate for treatment of advanced gastrointestinal stromal tumor: CALGB 150105 Study by Cancer and Leukemia Group B and Southwest Oncology Group. J Clin Oncol. 2008;20:5360–7.CrossRef Heinrich MC, Owzar K, Corless CL, Hollis D, Borden EC, Fletcher CD, Ryan CW, von Mehren M, Blanke CD, Rankin C, Benjamin RS, Bramwell VH, Demetri GD, Bertagnolli MM, Fletcher JA. Correlation of kinase genotype and clinical outcome in the North American Intergroup Phase III Trial of imatinib mesylate for treatment of advanced gastrointestinal stromal tumor: CALGB 150105 Study by Cancer and Leukemia Group B and Southwest Oncology Group. J Clin Oncol. 2008;20:5360–7.CrossRef
25.
go back to reference Prene H, Cools J, Mentens N, Folens C, Sciot R, Schoffski P, Oosterom AV, Marynen P, Debiec-Rychter M. Efficacy of the kinase inhibitor SU11248 against gastrointestinal stromal tumor mutants refractory to imatinib mesylate. Clin Cancer Res. 2006;12:2622–7.CrossRef Prene H, Cools J, Mentens N, Folens C, Sciot R, Schoffski P, Oosterom AV, Marynen P, Debiec-Rychter M. Efficacy of the kinase inhibitor SU11248 against gastrointestinal stromal tumor mutants refractory to imatinib mesylate. Clin Cancer Res. 2006;12:2622–7.CrossRef
26.
go back to reference Schittenhelm MM, Shiraga S, Schroeder A, Corbin AS, Griffith D, Lee FY, Bokemeyer C, Deininger AS, Druker BJ, Heinrich MC. Dasatinib (BMS-354825) a dual SRC/ABL kinase inhibitor, inhibits the kinase activity of wild type, juxtamembrane, and activation loop mutant KIT isoforms associated with human malignancies. Cancer Res. 2006;66:473–81.PubMedCrossRef Schittenhelm MM, Shiraga S, Schroeder A, Corbin AS, Griffith D, Lee FY, Bokemeyer C, Deininger AS, Druker BJ, Heinrich MC. Dasatinib (BMS-354825) a dual SRC/ABL kinase inhibitor, inhibits the kinase activity of wild type, juxtamembrane, and activation loop mutant KIT isoforms associated with human malignancies. Cancer Res. 2006;66:473–81.PubMedCrossRef
27.
go back to reference Srinivasan M, Sedmak D, Jewel S. Effect of fixatives and tissue processing on the content and integrity of nucleic acids. Am J Pathol. 2002;161:1961–71.PubMedCrossRef Srinivasan M, Sedmak D, Jewel S. Effect of fixatives and tissue processing on the content and integrity of nucleic acids. Am J Pathol. 2002;161:1961–71.PubMedCrossRef
28.
go back to reference Masuda N, Ohnishi T, Kawamoto S, Monden M, Okubo K. Analysis of chemical modification of RNA from formalin-fixed samples and optimization of molecular biology applications for such samples. Nucleic Acid Res. 1999;27:4436–43.PubMedCrossRef Masuda N, Ohnishi T, Kawamoto S, Monden M, Okubo K. Analysis of chemical modification of RNA from formalin-fixed samples and optimization of molecular biology applications for such samples. Nucleic Acid Res. 1999;27:4436–43.PubMedCrossRef
29.
go back to reference Williams C, Ponten F, Moberg C, Söderkvist P, Uhlén M, Pontén J, Sitbon G, Lundeberg J. A high frequency of sequence alterations is due to formalin fixation of archival specimens. Am J Pathol. 1999;155:1467–71.PubMedCrossRef Williams C, Ponten F, Moberg C, Söderkvist P, Uhlén M, Pontén J, Sitbon G, Lundeberg J. A high frequency of sequence alterations is due to formalin fixation of archival specimens. Am J Pathol. 1999;155:1467–71.PubMedCrossRef
30.
go back to reference Blay JY, Bonvalot S, Casali P, Choi H, Debiec-Richter M, Dei Tos AP, Emile JF, Gronchi A, Hogendoorn PC, Joensuu H, Le Cesne A, McClure J, Maurel J, Nupponen N, Ray-Coquard I, Reichardt P, Sciot R, Stroobants S, van Glabbeke M, van Oosterom A, Demetri GD. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20–21 March 2004, under the auspices of ESMO. Ann Oncol. 2005;16:566–78.PubMedCrossRef Blay JY, Bonvalot S, Casali P, Choi H, Debiec-Richter M, Dei Tos AP, Emile JF, Gronchi A, Hogendoorn PC, Joensuu H, Le Cesne A, McClure J, Maurel J, Nupponen N, Ray-Coquard I, Reichardt P, Sciot R, Stroobants S, van Glabbeke M, van Oosterom A, Demetri GD. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20–21 March 2004, under the auspices of ESMO. Ann Oncol. 2005;16:566–78.PubMedCrossRef
31.
go back to reference De Giorgi U. KIT mutations and imatinib dose effects in patients with gastrointestinal stroma tumours. J Clin Oncol. 2007;25:1146–7.PubMedCrossRef De Giorgi U. KIT mutations and imatinib dose effects in patients with gastrointestinal stroma tumours. J Clin Oncol. 2007;25:1146–7.PubMedCrossRef
32.
go back to reference Battochio A, Mohammed S, Winthrop D, Lefresne S, Mulder K, Chu Q, O’Hara C, Lai R. Detection of c-KIT and PDGFRA gene mutations in gastrointestinal stromal tumours: comparison of DHPLC and DNA sequencing methods using a single population-based cohort. Am J Clin Pathol. 2010;133:149–55.PubMedCrossRef Battochio A, Mohammed S, Winthrop D, Lefresne S, Mulder K, Chu Q, O’Hara C, Lai R. Detection of c-KIT and PDGFRA gene mutations in gastrointestinal stromal tumours: comparison of DHPLC and DNA sequencing methods using a single population-based cohort. Am J Clin Pathol. 2010;133:149–55.PubMedCrossRef
33.
go back to reference Ogino S, Gulley M, den Dunnen JT, Wilson RB. Standard mutation nomenclature in molecular diagnostics. J Mol Diagn. 2007;9:1–6.PubMedCrossRef Ogino S, Gulley M, den Dunnen JT, Wilson RB. Standard mutation nomenclature in molecular diagnostics. J Mol Diagn. 2007;9:1–6.PubMedCrossRef
Metadata
Title
A quality control program for mutation detection in KIT and PDGFRA in gastrointestinal stromal tumours
Authors
Isabelle Hostein
Maria Debiec-Rychter
Sylvianne Olschwang
Pierre-Paul Bringuier
Louisa Toffolati
David Gonzalez
Sébastien Forget
Fabienne Escande
Lucyna Morzuch
Elena Tamborini
Nicolas Faur
Silvana Pilotti
Paolo Dei Tos
Jean-François Emile
Jean-Michel Coindre
Publication date
01-05-2011
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 5/2011
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-011-0375-0

Other articles of this Issue 5/2011

Journal of Gastroenterology 5/2011 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.