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Managing multiple mining crisis events simultaneously

Managing multiple mining crisis events simultaneously

In fast-moving mining operations, multiple events may need managing across several locations globally. Yet using the traditional business resilience model limits the ability to gain and maintain situational awareness, manage resource allocation and fatigue, as well as lacking the necessary flexibility in the response.

The only way to manage multiple events simultaneously is through a tech-driven operational resilience program. This provides the capability to maintain control of several events at once across different points of time and geographies. Business as usual (BAU) must continue as best as possible in the circumstances, while ensuring that an event is managed to completion and opportunities for improvement are not missed.

Despite Covid-19 challenging operations during the past two years and presenting new levels of complexity for business leaders, traditional threats to businesses remain. For example, threats such as reputational, whistle-blower, natural perils, and cybersecurity have continued throughout the pandemic, which can all significantly impact operational continuity. And with resources diverted towards the pandemic response, this has increased the potential for vulnerability in other areas.

Dynamiq’s business resilience platform, EMQnet enables reporting, tracking and monitoring progress over time. And data captured through the platform allows for trend analysis, helping build an understanding of where ongoing issues are occurring and any identifying areas that require focus. The platform also has a map feature that displays incidents around the world, allowing a snapshot of the various event types across the Globe. All these features offer increased accessibility of vital information.

“Having multiple events within EMQnet will allow people to understand what their focus is at that particular point in time. The paper-based or traditional method of crisis management or business resilience is difficult to follow if there is a need to manage multiple events. And it’s difficult to maintain situational awareness to get back into that focused mindset when you are changing between events. Whereas EMQnet allows you to refresh yourself through reading the status board and confirming the status of tasks and management of stakeholders,” explains Lucas Saunders, Head of Advisory at Dynamiq.

Managing resources during multiple events

A key consideration in managing multiple events is allocation of resources, especially when different event types may be at varying stages. Some areas may require more attention than others and need prioritising, yet full oversight is necessary across all events should any escalations occur.

In a crisis response, leaders get to see their team perform under pressure, which helps identify talent with the ability to handle stressful environments. While at the other end, any members of staff that may be challenged in particular situations can either receive extra training to address deficiencies or be redeployed to other operations where they are less exposed.

Leaders must also recognise opportunities for continuous improvement through lessons learned, and ensure these learnings are shared up, across and down through the organisation to build capability. However, opportunities can sometimes be missed when responding to multiple events at once.

“You’ve got to be able to manage the event cycle,” says Saunders. “The instinct is that once an event is dealt with to return to BAU and continue on, not taking the time to pause and reflect.

“If you’re not doing those after-action reviews, and you’re looking for opportunities to improve, you’re just going to continue to go from event to event. The entire purpose of conducting after action reviews is to enhance the organisational business resilience capability.”

When responding to multiple events, it is often necessary to involve other teams. EMQnet can add multiple teams, both internal and external experts, to an event to enable collaboration between several parties and strengthen the response. 

“Take a cyclone or severe weather event as an example. You potentially have a regional corporate office and multiple mine sites within the cyclone-prone area. The organisation can start an event in EMQnet and invite multiple teams,” explains Saunders. “Some clients did this during cyclone Debbie [in Australia] and it’s similar to the approach taken with Covid. They can have the one event and develop those plans across as many sites or locations as they need.”

Challenges with multiple events management

Fatigue is a key consideration in the effective and efficient management of multiple events affecting an organisation, particularly in heavy industries. Response fatigue must be managed to avoid workers experiencing burnout, especially when trying to perform under duress or dealing with stress in a crisis. Working across multiple events simultaneously can significantly intensify the strain on all personnel.

“Fatigue is a real issue. It impacts their decision-making process. It impacts their ability to do business as usual. It also impacts their families and their loved ones,” says Saunders.

And post-pandemic, leaders also need to be aware of the potential for both skill fade and a loss of mental stamina after workers have been absent from the workplace for extended periods in the past two years.

“Then there’s safety. Because people with fatigue will make poor decisions. Identifying and managing that fatigue through relieving people in place or putting alternate people in various roles can help mitigate that,” adds Saunders. 

EMQnet platform records who is working on any particular event, indicating who may need a break and when. The platform builds a common operating picture across multiple events at once to enable operations continuity and establish a cohesive response for as long as an event lasts and however many incidents there may be, and at all times monitoring personnel participation and involvement in the event management.

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Managing Adverse Events with Superior Combination Therapies in RCC

Managing Adverse Events with Superior Combination Therapies in RCC

In an interview with Targeted OncologyTM, Thomas Hutson, MD, PharmD, director of the urologic oncology program for Texas Oncology Baylor University Medical Center, discusses the challenges that naturally come when adding therapies to treatment, such as the use of lenvatinib (Lenvima) and pembrolizumab (Keytruda) in patients with renal cell carcinoma (RCC). 

According to Hutson, with combination therapies, there will naturally be more adverse events (AEs) to manage than with monotherapy, but efficacy from the combination treatment will increase. Therefore, Hutson describes strategies, such as dose reduction, to manage additional AEs and make sure patients continue to see a superior benefit on a combination than they would with monotherapy.

The phase 3 CLEAR study (NCT02811861) demonstrated that the combinations of lenvatinib and pembrolizumab or lenvatinib and everolimus (Afinitor) were superior to sunitinib (Sutent) in patients with advanced RCC for progression-free survival, objective response rate, and overall survival.

However, nearly all patients in the study and combination therapy experienced treatment-related AEs with 67.3% of patients treated with lenvatinib plus pembrolizumab compared with 49.7% in the sunitinib arm that led to dose reductions. Hutson says being proactive about dose reductions in this patient population allows patients to still experience the superior benefits without having to lose those benefits as clinicians manage AEs. He discusses empowering the patient to be a part of these decisions to help find the best dose for them and how the health-related quality of life is also still favorable with combination therapies.  

TRANSCRIPTION:

0:08 | As we start adding on therapies, there is going to be an addition of [AEs] and that’s just the way it is. Again, I think the surprise has been that if you can work through the AEs with the patient and optimize the dose. There is a dose response effect for people that as the higher the dose, the more chance of benefit, but also the more toxicity, so they go hand in hand.

0:34 | So, it’s trying to optimize and individualize the dose for the patients sitting in front of you, using the standard for how we dose people, which is starting off at full dose, allowing AEs to declare themselves, then lowering the dose and optimizing it to try to keep that highest dose intensity. Sometimes that is just taking breaks periodically and allowing them to stay at the same dose, but saying, “Hey, when that AE gets to that point, that it’s really impacting your quality of life, take a break for a couple days, when it gets better go back on it.” Patients like that they have power, they’re in control of that, and if that doesn’t happen then go into the lower dose. So that kind of strategy is important.

1:18 | As we combine therapies, we’re going to have added to have additive toxicity. Where we can feel comfortable and point your patients too and say, “Hey, if we can get this to work out and if we can find this right dose for you, then the data we have so far from the trials to health-related quality-of-life data, you’re actually going to start feeling better as your tumor gets smaller.” The health-related quality of life data shows us that, that even though there’s more overall AEs with the combinations, the health-related quality of life is improving over the comparator drug that had less AEs.

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Dr. Lacouture on managing dermatological adverse events with apalutamide in prostate cancer

Dr. Lacouture on managing dermatological adverse events with apalutamide in prostate cancer

Although apalutamide (Erleada) is a common and safe treatment, patients with prostate cancer who take this drug are still at risk for dermatologic adverse events.

To investigate the severity and prevalence of this specific adverse event, Mario E. Lacouture, MD, and investigators conducted a study that will help to manage and counsel patients with prostate cancer in the future, especially with the expanded approval of apalutamide in this space.1 Lacouture is a dermatologist at Memorial Sloan Kettering Cancer Center in New York, New York.

Please discuss the background for this study.

We were very interested in adverse events related to apalutamide, as many patients are referred to us in oncodermatology at Memorial Sloan Kettering Cancer Center [(MSK)] for the appearance of these dermatologic adverse events that may affect quality of life, or dose intensity of therapy. We identified that these toxicities appear suddenly and were limiting dosing of these patients. We found that there was little data published on this topic, so we decided to analyze a cohort of patients treated at MSK.

What were the notable findings? Were any of them surprising to you or your co-authors?

We analyzed 300 patients treated at MSK with apalutamide. We found that, consistent with data from the SPARTAN [(NCT01946204)] and TITAN [(NCT02489318)] trials,2-3 approximately [one] third of these patients developed dermatologic adverse events. Most notably, [they developed rashes], but we also identified that more than 20% developed very dry skin, which may also lead to its own set of symptoms, such as pruritis. What was interesting about this is that the majority of patients were able to stay on the dose of the apalutamide, and only about 1 out of 20 patients needed to have the drug discontinued because of an adverse event.

What is the take-home message for the practicing urologist?

The take-home message of our research, in more than 300 patients treated with apalutamide at MSK in collaboration with our oncology colleagues, is that the majority of patients that develop a rash on apalutamide can be treated with topical or systemic corticosteroids and antihistamines. And following a dose interruption and rechallenge, the majority of these patients can stay on therapy.

Is there anything else you feel our audience should know about this topic?

It’s understandable that there are so many issues that are going on in the daily lives of our patients and [in] caring for these patients. So, hopefully, these findings will help alleviate some of the concerns about dermatological adverse events [related] to the AR inhibitor apalutamide. As has been shown, although [patients] may develop a rash, which can be grade 3 in about 10% of cases, after the rash is treated and the patients are rechallenged with the drug, [the majority of these patients] can continue receiving therapy and only a minority of patients really need to have their drug discontinued because of this adverse event.

References

1. Pan A, Reingold RE, Zhao JL, et al. Dermatologic adverse events in prostate cancer patients treated with androgen receptor inhibitor apalutamide. J Urol. Published online January 12, 2022.doi:10.1097/JU.0000000000002425

2. A study of apalutamide (ARN-509) in men with non-metastatic castration-resistant prostate cancer (SPARTAN). ClinicalTrials.gov. Updated January 28, 2022. Accessed February 1, 2022. https://clinicaltrials.gov/ct2/show/NCT01946204

3. A study of apalutamide (JNJ-56021927, ARN-509)plus androgen deprivation therapy (ADT) versus ADT in participants with mHSPC (TITAN). ClinicalTrials.gov. Updated January 28, 2022. Accessed February 1, 2022. https://clinicaltrials.gov/ct2/show/NCT02489318