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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.
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.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
634 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Pathological complete response (breast and lymph nodes)primary | Paclitaxel + carboplatin + veliparib | 316 | 53% | - | <0.0001 (veliparib + carboplatin vs paclitaxel alone); 0.36 (vs paclitaxel + carboplatin) | link |
| Paclitaxel + carboplatin | 160 | 58% | ||||
| Paclitaxel alone | 158 | 31% |
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.
This is the paper Europe PMC returns for registry id NCT02032277 with the most citations, so it is the natural first reading for anyone following the BrighTNess trial. Read the abstract above alongside the trial page and the registry entry; the record was linked automatically and its figures have not been checked by hand.
Shares Cyclophosphamide, Platinum agents, Carboplatin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Paclitaxel / nab-paclitaxel, Carboplatin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Doxorubicin, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Platinum agents, Cytotoxic chemotherapy and the tag subtype-trials.
Shares Sibylle Loibl and the tag subtype-trials.
Shares Doxorubicin, Cyclophosphamide and the tag subtype-trials.
Shares Paclitaxel / nab-paclitaxel, Carboplatin and the tag subtype-trials.
Shares AbbVie (incl. ImmunoGen, Capstan) and the tag subtype-trials.