BrighTNess
BrighTNess showed that adding the platinum drug carboplatin to standard chemotherapy before surgery makes triple-negative breast tumours vanish completely more often, and later that fewer people relapsed, while the PARP inhibitor veliparib added on top made no difference.
Overview
BrighTNess was a double-blind placebo-controlled phase 3 trial in stage II to III triple-negative breast cancer. Patients were randomised two to one to one to neoadjuvant paclitaxel with carboplatin and veliparib, paclitaxel with carboplatin and placebo, or paclitaxel with two placebos, all followed by doxorubicin and cyclophosphamide before surgery.
Adding carboplatin and veliparib to paclitaxel significantly increased the pathological complete response rate compared with paclitaxel alone, but adding veliparib to carboplatin and paclitaxel did not increase it further, so the benefit came from carboplatin. Long-term follow-up published in 2022 showed that carboplatin also improved event-free survival, without a difference in overall survival at that point. With GeparSixto and CALGB 40603, BrighTNess put carboplatin into neoadjuvant regimens for triple-negative disease, on which KEYNOTE-522 later built.
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