Software complexity and maintenance costs

The effects of software complexity on the costs of Cobol maintenance projects within a large commercial bank are examined, and the impact of software complexity on the costs of software maintenance projects in a traditional information-system (IS) environment is estimated using a previously developed economic model of software maintenance. The model uses a multidimensional approach to measuring software complexity; other project factors that can be controlled by managers and that are believed to affect maintenance project costs are controlled for by the model. It is shown that software maintenance costs are affected significantly by software complexity in terms of module size, procedure size, and branching complexity. Dollar estimates are provided of the magnitude of the impact of software complexity on maintenance costs at a typical commercial site; the costs are high enough to justify complexity control and monitoring.Center for Information Systems ResearchCenter for the Management of Technology and Information in OrganizationsNational Science FoundationCenter for the Management of Technology and Information in OrganizationsInternational Financial Services Research CenterNational Science Foundation Grant No. SES-870904

Canadian Perspectives: Update on Inhibition of ALK-Positive Tumours in Advanced Non-Small-Cell Lung Cancer

Background: Inhibition of the anaplastic lymphoma kinase (ALK) oncogenic driver in advanced non-small-cell lung carcinoma (NSCLS) improves survival. In 2015, Canadian thoracic oncology specialists published a consensus guideline about the identification and treatment of ALK-positive patients, recommending use of the ALK inhibitor crizotinib in the first line. New scientific literature warrants a consensus update. Methods: Clinical trials of ALK inhibitor were reviewed to assess benefits, risks, and implications relative to current Canadian guidance in patients with ALK-positive NSCLS. Results: Randomized phase III trials have demonstrated clinical benefit for single-agent alectinib and ceritinib used in treatment-naïve patients and as second-line therapy after crizotinib. Phase II trials have demonstrated activity for single-agent brigatinib and lorlatinib in further lines of therapy. Improved responses in brain metastases were observed for all second- and next/third-generation ALK tyrosine kinase inhibitors in patients progressing on crizotinib. Canadian recommendations are therefore revised as follows: (1) Patients with advanced nonsquamous NSCLS have to be tested for the presence of an ALK rearrangement. (2) Treatment-naïve patients with ALK-positive disease should initially be offered single-agent alectinib or ceritinib, or both sequentially. (3) Crizotinib-refractory patients should be treated with single-agent alectinib or ceritinib, or both sequentially. (4) Further treatments could include single-agent brigatinib or lorlatinib, or both sequentially. (5) Patients progressing on ALK tyrosine kinase inhibitors should be considered for pemetrexed-based chemotherapy. (6) Other systemic therapies should be exhausted before immunotherapy is considered. Summary: Multiple lines of ALK inhibition are now recommended for patients with advanced NSCLS with an ALK rearrangement