Tamoxifen in treatment of hepatocellular carcinoma: a randomised controlled trial

Background Results from small randomised trials on tamoxifen in the treatment of hepatocellular carcinoma (HCC) are conflicting, We studied whether the addition of tamoxifen to best supportive care prolongs survival of patients with HCC. Methods Patients with any stage of HCC were eligible, irrespective of locoregional treatment. Randomisation was centralised, with a minimisation procedure accounting for centre, evidence of disease, and time from diagnosis. Patients were randomly allocated best supportive care alone or in addition to tamoxifen, Tamoxifen was given orally, 40 mg per day, from randomisation until death. Results 496 patients from 30 institutions were randomly allocated treatment from January, 1995, to January, 1997. Information was available for 477 patients. By Sept 15, 1997, 119 (50%) of 240 and 130 (55%) of 237 patients had died in the control and tamoxifen arms, respectively. Median survival was 16 months and 15 months (p=0.54), respectively, No differences were found within subgroups defined by prognostic variables. Relative hazard of death for patients receiving tamoxifen was 1.07 (95% CI 0.83-1.39). Interpretation Our findings show that tamoxifen is not effective in prolonging survival of patients with HCC

Sustainable marketing. Handle the unknown

The present study carries out a systematic review of the literature, and aims to identify and describe the evolution of the paradigm of sustainable marketing. Specifically, we aim to define the knowledge domain of sustainable marketing also highlighting the links with other research fields

Alternative Logics for Innovation: a call for service innovation research

The aim of this paper is to frame innovation within S-D Logic and Service Science and propose a framework in order to launch a call for service innovation research. Methodology. Through a review of the literature, we analyse innovation using different approaches such as goods-dominant logic, S-D logic, and cognitive-relational studies as a transitional view. Findings. We outline the main elements of each approach and develop a framework with a focus on their differences in terms of drivers, outcomes, processes, and actors‘ roles. Innovation within goods-dominant logic is analysed in terms of new product development and new service development. In both of these research streams, innovation is seen as an output (a new good or a new service), coming out from an organisational internal process where the firm is the main actor, protecting its knowledge with an owner and secret approach. The cognitive-relational approach provides a different perspective on innovation in which the drivers of the process are knowledge, competencies, and relationships. The firm is still the main innovator, with the key users and partners acting as sources of knowledge that is used to produce superior value for the recipients. Recognising the role of resource-based view, S-D logic moves the focus to value-creating innovation. This is an ‗open‘ innovation process in which all actors in the network can mobilise their resources to become co-innovators and co-producers of value. Research implications Our theoretical findings represent a good basis upon which further studies of innovation can be undertaken. We call for the development of models and innovation patterns within S-D logic and Service Science. Originality/Value Innovation is a key theme in service systems and service science. However, studies are widely based on a goods-dominant logic, even when the offering is itself a service. This paper offers a new and wider perspective on innovation to frame the phenomenon in S-D logic as a basis for further studies