In order to determine the benefit of multiple drug chemotherapy compared to single drug chemotherapy, the National Cancer Institute sponsored a large clinical study comparing the adjuvant chemotherapy regimen of CMFVP (Cytoxan® [cyclophosphamide], methotrexate, 5-fluorouracil, Oncovin® [vincristine], and prednisone) versus single-agent Alkeran® (melphalan) in women with operable breast cancer involving axillary lymph nodes. Patients enrolled on this clinical study have now been followed for over 15 years from initial treatment.

At 10 years from initial treatment, 48% of women treated with CMFVP were alive without evidence of cancer recurrence compared to 35% treated with single-agent Alkeran®. Patients treated with CMFVP also survived longer, with 56% of patients alive 10 years from treatment compared to only 43% of patients treated with Alkeran®. The average length of survival for patients treated with CMFVP was almost 12 years as compared to 7 years for Alkeran®. In summary, this clinical study helped confirm that adjuvant chemotherapy was beneficial for the treatment of women with node positive breast cancer and further demonstrated that multi-drug chemotherapy is superior to single-agent chemotherapy. ( Journal of Clinical Oncology, Classic Papers and Current Comments, Vol 1, No 1, pp 85-93, 1996)