Experimental Hematology & Oncology: More 4K Press
Sept 26, 2023 14:40:35 GMT
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Post by luxetvox on Sept 26, 2023 14:40:35 GMT
The article is quite long: ehoonline.biomedcentral.com/articles/10.1186/s40164-023-00444-9
It's a summary/overview of "Recent advances and future perspectives in the therapeutics of prostate cancer". Here's the section on 4K (footnotes are referenced here, but only available if you click on the link to the article). I like the bolded section at the end, which references the value proposition of 4K. Now, we just need to sell it.
4K score
The 4K score is a blood-based test, developed by OPKO Health Miami, FL, USA. Patients with abnormal PSA or DRE levels undergo a 4K score test to decide whether an initial biopsy is needed and patients for whom repeat biopsy is being considered. The possible candidates for this test are men with a family history of PC, but any man above 35 years of age, curious about his risk, can have this test [76].
The 4K score utilizes four levels of kallikreins- fPSA, iPSA, tPSA, and human kallikrein 2 (hK2) along with the patient data, such as DRE, age, and initial biopsy outcomes in a specific algorithm, providing results in the form of percentages from 0 to 100%. This percentage forecasts the probability of significant high-grade PC before biopsy. The 4K score can differentiate between patients with aggressive and slow PC. The patients with a Gleason score > 7 from those with a Gleason score < 7 have been considered as an aggressive in nature. The test can evaluate the threat of distant metastasis within 20 years of performing the test [69].
To validate the clinical utility and significance of 4K scores, Parekh et al. performed a trial in the United States that included 1021 men considered for biopsy, where 23% of men were found to have a Gleason score ≥ 7 PC. The 4K score demonstrated better accuracy than the Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPT-RC). The overall reduction in biopsies was reported to range between 30 and 58% depending on different thresholds, with only 1.3–4.7% cases of late diagnosis. When using a ≥ 6% probability of having a Gleason score ≥ 7 as the threshold for performing a biopsy, there would be a 30% reduction in biopsies with only 1.3% delayed cases. Similarly, when ≥ 9% and ≥ 15% is the threshold, the reduction in biopsies is 43% and 58%, with 2.4% and 4.7% delayed cases, respectively [80].
A case–control study of multi-ethnic groups involving 1,667 PC incidents and 691 controls with PSA levels of ≥ 2 ng/mL was conducted. The multi-ethnic groups included were native Hawaiians, White men, Latinos, African Americans, and Japanese. The outcomes demonstrated that among all ethnic groups, the 4K score has a higher ability to differentiate overall and aggressive PC compared to tPSA and tPSA + fPSA. Thus, the 4K score appears to be a better alternative in a multi-ethnic population, providing evidence of its more comprehensive utility [81]. Various studies have found that the 4K score test decreases the cost while simultaneously improving the quality of patient care [82, 83]. A comparative study of the PHI and 4K score showed that both increased discrimination while predicting high-grade PC and PC [84].
It's a summary/overview of "Recent advances and future perspectives in the therapeutics of prostate cancer". Here's the section on 4K (footnotes are referenced here, but only available if you click on the link to the article). I like the bolded section at the end, which references the value proposition of 4K. Now, we just need to sell it.
4K score
The 4K score is a blood-based test, developed by OPKO Health Miami, FL, USA. Patients with abnormal PSA or DRE levels undergo a 4K score test to decide whether an initial biopsy is needed and patients for whom repeat biopsy is being considered. The possible candidates for this test are men with a family history of PC, but any man above 35 years of age, curious about his risk, can have this test [76].
The 4K score utilizes four levels of kallikreins- fPSA, iPSA, tPSA, and human kallikrein 2 (hK2) along with the patient data, such as DRE, age, and initial biopsy outcomes in a specific algorithm, providing results in the form of percentages from 0 to 100%. This percentage forecasts the probability of significant high-grade PC before biopsy. The 4K score can differentiate between patients with aggressive and slow PC. The patients with a Gleason score > 7 from those with a Gleason score < 7 have been considered as an aggressive in nature. The test can evaluate the threat of distant metastasis within 20 years of performing the test [69].
To validate the clinical utility and significance of 4K scores, Parekh et al. performed a trial in the United States that included 1021 men considered for biopsy, where 23% of men were found to have a Gleason score ≥ 7 PC. The 4K score demonstrated better accuracy than the Prostate Cancer Prevention Trial Risk Calculator 2.0 (PCPT-RC). The overall reduction in biopsies was reported to range between 30 and 58% depending on different thresholds, with only 1.3–4.7% cases of late diagnosis. When using a ≥ 6% probability of having a Gleason score ≥ 7 as the threshold for performing a biopsy, there would be a 30% reduction in biopsies with only 1.3% delayed cases. Similarly, when ≥ 9% and ≥ 15% is the threshold, the reduction in biopsies is 43% and 58%, with 2.4% and 4.7% delayed cases, respectively [80].
A case–control study of multi-ethnic groups involving 1,667 PC incidents and 691 controls with PSA levels of ≥ 2 ng/mL was conducted. The multi-ethnic groups included were native Hawaiians, White men, Latinos, African Americans, and Japanese. The outcomes demonstrated that among all ethnic groups, the 4K score has a higher ability to differentiate overall and aggressive PC compared to tPSA and tPSA + fPSA. Thus, the 4K score appears to be a better alternative in a multi-ethnic population, providing evidence of its more comprehensive utility [81]. Various studies have found that the 4K score test decreases the cost while simultaneously improving the quality of patient care [82, 83]. A comparative study of the PHI and 4K score showed that both increased discrimination while predicting high-grade PC and PC [84].
