# 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

Source: https://onco.cc/key-papers/paper-geyer-brightness-4-year-follow-up-ann-oncol-2022/  
OnCo record `paper-geyer-brightness-4-year-follow-up-ann-oncol-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The 4.5-year follow-up of BrighTNess showing that adding carboplatin to pre-surgery chemotherapy in 634 women cut relapse or death by about 40 percent without more second cancers, while adding the PARP inhibitor veliparib added nothing.

## Summary

Geyer, Sikov, Huober, Rugo and colleagues report follow-up of BrighTNess, in which 634 women with untreated stage II to III triple-negative breast cancer were randomised 2:1:1 to weekly paclitaxel with carboplatin plus veliparib (316), carboplatin plus placebo (160) or placebo alone (158), all followed by doxorubicin and cyclophosphamide. The co-primary endpoint of higher pathological complete response with veliparib was not met, so survival analyses are descriptive. At a median 4.5 years the event-free survival hazard ratio for carboplatin plus veliparib versus paclitaxel alone was 0.63 (95 percent confidence interval 0.43 to 0.92, p=0.02) but 1.12 (0.72 to 1.72) versus carboplatin without veliparib; post hoc, carboplatin versus paclitaxel alone gave 0.57 (0.36 to 0.91, p=0.02). Overall survival and rates of myelodysplastic syndrome, acute myeloid leukaemia and other second malignancies did not differ between arms.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Tags: tnbc-evidence
- Journal: Annals of Oncology
- Year: 2022
- DOI: 10.1016/j.annonc.2022.01.009
- Authors: Geyer CE, Sikov WM, Huober J, et al.
- Findings: Event-free survival, carboplatin plus veliparib vs paclitaxel alone: hazard ratio 0.63 (95 percent CI 0.43 to 0.92), p=0.02; vs carboplatin alone 1.12 (0.72 to 1.72).; Post hoc, carboplatin vs paclitaxel alone: 0.57 (0.36 to 0.91), p=0.02.; No difference in overall survival or in myelodysplastic syndrome, acute myeloid leukaemia or other second cancers.
- What it means: The third trial to show carboplatin's benefit persists beyond pathological complete response and the trial that closed the neoadjuvant PARP inhibitor route in unselected triple-negative disease; PARP inhibition survives only in germline BRCA carriers.
- Caveats: Survival analyses descriptive because the veliparib co-primary endpoint failed.; Carboplatin-alone comparison is post hoc.

## Sources

- Ann Oncol 2022: https://doi.org/10.1016/j.annonc.2022.01.009
- PubMed: https://pubmed.ncbi.nlm.nih.gov/35093516/
- ClinicalTrials.gov NCT02032277: https://clinicaltrials.gov/study/NCT02032277

## Connected records

- key papers: [Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial](https://onco.cc/key-papers/paper-brightness-lancet-oncol-2018/)
- cancers: [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- technologies: [PARP inhibitors](https://onco.cc/technologies/parp-inhibitor/), [Platinum agents](https://onco.cc/technologies/platinum/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Paclitaxel / nab-paclitaxel](https://onco.cc/drugs/paclitaxel/)
- terms: [Event-free / disease-free survival (EFS, DFS, iDFS, RFS)](https://onco.cc/terms/efs/), [Pathologic complete response (pCR)](https://onco.cc/terms/pcr/)
- trials: [BrighTNess](https://onco.cc/trials/brightness/)
- people: [Charles E. Geyer Jr.](https://onco.cc/people/charles-geyer/), [Hope S. Rugo](https://onco.cc/people/hope-rugo/)
- journals: [Annals of Oncology](https://onco.cc/journals/annals-of-oncology/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)

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