March 2022: Long-term outcomes from the BrighTNess trial support inclusion of carboplatin in neoadjuvant chemotherapy for early-stage TNBC.

The aim of this study was to assess whether the improvement in pCR observed in the BrighTNess trial (NCT02032277) with the addition of carboplatin, with or without veliparib, to paclitaxel is associated with long-term survival benefits and/or an increased risk of second malignancies. Long-term efficacy and safety outcomes from the BrighTNess trial with a minimum of 4 years of post-surgery follow-up are reported.

Highlights

• At 4.5 years, adding carboplatin to neoadjuvant paclitaxel followed by AC improved event-free survival (EFS) in stage II-III TNBC.
• Adding veliparib to carboplatin-containing neoadjuvant chemotherapy did not impact long-term outcomes in TNBC.
• Patients with pathological complete response had significantly better event-free survival regardless of germline BRCA status.
• The incidence of AML/MDS and other second malignancies was not increased by adding carboplatin or veliparib.
• Long-term results of the BrighTNess trial support inclusion of carboplatin in neoadjuvant chemotherapy for stage II-III TNBC.

Conclusion: Improvement in pCR with the addition of carboplatin was associated with long-term EFS benefit with a manageable safety profile, and without increasing the risk of second malignancies, whereas adding veliparib did not impact EFS. These findings support the addition of carboplatin to weekly paclitaxel followed by doxorubicin and cyclophosphamide neoadjuvant chemotherapy for early-stage TNBC.

Geyer CE, Sikov WM, Huober J, et al. Long-term efficacy and safety of addition of carboplatin with or without veliparib to standard neoadjuvant chemotherapy in triple-negative breast cancer: 4-year follow-up data from BrighTNess, a randomized phase III trial. Ann Oncol. 2022 Apr;33(4):384-394. doi: 10.1016/j.annonc.2022.01.009.

• PubMed Link: https://pubmed.ncbi.nlm.nih.gov/35093516/