BRAF inhibitor treatment is feasible in the oldest-old advanced melanoma patients

Although new compounds have improved the treatment landscape of metastatic melanoma, very limited data exist on the efficacy and safety of treating older patients with novel agents. Here, we provide results of BRAF (BRAFi) +/- MEK (MEKi) inhibitor treatment in patients over 75 years (oldest-old patients) with metastatic melanoma. Between 2011 and 2020, 34 consecutive patients with metastatic melanoma over 75 years of age (range 75-89) were treated with BRAFi +/- MEKi at the Comprehensive Cancer Center of Helsinki University Hospital. Data on clinical and histopathological features, toxicity, response rate (RR), progression-free survival (PFS) and overall survival (OS) were collected. Patients were treated with BRAFi (n = 22) or BRAFi in combination with MEK inhibitor (MEKi) (n = 12). Grade 1-2 adverse events occurred in 68% of the patients, 32% had grade 3 adverse effects, dose reductions were made for 41% of patients and 29% terminated treatment due to toxicity. Overall, the RR was 62%. Complete responses were achieved in 27% of the patients, and 35% had partial responses. The median PFS was 8 months (range 0-57), and the median OS was 15 months (range 0-71). Tailored BRAFi +/- MEKi treatment for older patients is feasible. Adverse effects occur frequently but are manageable by dose adjustment. The occurrence of toxicity of monotherapy was similar to that of combination therapy. The RR and median OS from our retrospective study are comparable with those reported in clinical trials and combination therapy produced somewhat more and longer-lasting responses. Hence, it seems that older patients may benefit from BRAFi treatment.Peer reviewe

Making connections: harnessing the diversity of strategy-as-practice research

Strategy-as-practice (SAP) has become one of the most vibrant areas of contemporary strategy research in the past two decades. As the field has grown significantly, we have witnessed an emergence of distinct streams of research within the SAP research community. Thus, it is time to take stock of this body of work to better understand the structure of the field and provide a refreshed agenda for future research. Our review is based on bibliometric analysis and a systematic review of 340 articles. As a result, we identify the following six clusters of research: praxis, sensemaking, discourse, sociomateriality, institutional and process. Co-citation analysis shows significant disconnects between some of these clusters. Building on our review, we identify various ‘crossing strategies’ for connecting across four disconnects: (i) micro and macro; (ii) sociomaterial and discourse; (iii) critical and more mainstream; and (iv) practice and process perspectives. By harnessing diversity, these crossing strategies suggest rich agendas for future SAP research, ranging from digitalization to gender inequality

Managing digital servitization toward smart solutions: Framing the connections between technologies, business models, and ecosystems

The present study extends the discussion on product manufacturers' digital servitization toward smart solutions by outlining and reviewing the existing literature on digital servitization and smart solutions. We focus on potential configurations based on technologies, business models, and ecosystems to understand how this transition can be managed through the process of reconfiguration. We define smart solutions as an advanced state of product-service-software systems, and we use moving vehicles as a case in point. We base our discussion on a configurational research approach, examining the role of advanced technologies (e.g., artificial intelligence), novel business models, and modern ecosystems (e.g., platforms and innovation ecosystems) in shaping digital servitization toward smart and autonomous solutions. We identify gaps in the literature, offer an analytical framework, suggest avenues for future research, and contribute by laying the theoretical foundations and proposing managerial directions for a digital servitization journey toward smart solutions. By so doing, we present the papers accepted to the current IMM special issue on “Moving toward autonomous solutions: The role of Product-Service-Software Systems”, which this review article introduces.©2022 Elsevier. This manuscript version is made available under the Creative Commons Attribution–NonCommercial–NoDerivatives 4.0 International (CC BY–NC–ND 4.0) license, https://creativecommons.org/licenses/by-nc-nd/4.0/fi=vertaisarvioimaton|en=nonPeerReviewed

Exploring the relationship between product-service system and profitability

Over the last few decades there has been a significant change in the economic output worldwide, and services have become more and more important. Manufacturers strengthen their competitive position by relying on service offerings, which has been referred to as “servitization”. A particular research stream within such framework recalls product service systems (PSS) as the integration of products and services to deliver value to the customer. The purpose of the paper is to examine the relationship between PSS categories and profitability. The empirical analysis uses a dataset of 10,051 companies on machinery manufacturing industry drawn from the ORBIS database. The analysis further considers the location of firms and differentiates between the European and BRIC countries. The findings reveal that profitability could be represented by an ideal bell curve if we consider on the horizontal axis a spectrum of PSS with an increasing servitization level. In fact, a higher profitability is expected for those companies offering central PSS categories (Product-Oriented, Service-Oriented and Use-Oriented PSS) in contrast to what happens for Integration-Oriented and Result-Oriented PSS categories which are closer, respectively, to the “pure product” and the “pure service” configurations extremes. Finally, considering the stage of economic development, the choice of offering Integrated-Oriented PSS brings to a better financial performance in BRIC countries, whereas, in the same setting, Use-Oriented PSS choice has a negative impact