Alan P. Venook, MD, a professor in the Department of Medicine (Hematology/Oncology) at the University of California, San Francisco, describes factors that contribute to the geographic variations seen in therapies utilized to treat cancer in the United States and Europe.
Primarily, pharmaceutical companies determine where they will pursue the development of new agents. As an example, the angiogenesis inhibitor bevacizumab was largely development in the US. In contrast, Venook notes, the antiangiogenic agent aflibercept was developed largely in Europe and, as a result, it is not used as frequently in the US.
The treatments utilized by physicians are driven by other regional differences, Venook suggests. In the US, treatment selection is driven by guidelines and the pharmaceutical industry has less of an impact. However, the reverse is true in Europe. Overall, when comparing the two, it is unclear which is the best option, Venook believes. However, it is clear that collaboration between the regions helps foster better treatment of patients.
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