Adding Carboplatin With or Without Veliparib to Neoadjuvant Chemotherapy: Long-Term Follow-up in Triple-Negative Breast Cancer
Posted: Monday, October 18, 2021
In the phase III BrighTNess trial, adding carboplatin with or without veliparib to neoadjuvant chemotherapy seemed to significantly improve the pathologic complete response, with an acceptable safety profile, in patients with operable triple-negative breast cancer. Sibylle Loibl, MD, of the German Breast Group, Neu-Isenburg, and colleagues presented the data on event-free survival, overall survival, and second malignancies from at least 4 years after surgery during the European Society for Medical Oncology (ESMO) Congress 2021 (Abstract 119O).
“Adding carboplatin to paclitaxel improved pathologic complete response and event-free survival without increasing myelodysplastic syndromes or acute myeloid leukemia,” the investigators remarked. “[However, the] addition of veliparib did not impact pathologic complete response or event-free survival.”
Patients with untreated stage II or III disease were randomly assigned in a 2:1:1 ratio to receive paclitaxel plus carboplatin and veliparib (n = 316), paclitaxel plus carboplatin (n = 160), or paclitaxel alone (n = 158); they then received four cycles of doxorubicin plus cyclophosphamide every 2 to 3 weeks. Follow-up data were provided for a median of 4.5 years.
The hazard ratio for event-free survival of paclitaxel plus carboplatin and veliparib versus paclitaxel alone was 0.63 (P = .016); the hazard ratio for paclitaxel plus carboplatin and veliparib versus paclitaxel plus carboplatin was 1.12 (P = .620). Based on the post hoc analysis, the hazard ratio for event-free survival with paclitaxel plus carboplatin versus paclitaxel alone was 0.57 (P = .018). Death occurred in 12%, 10%, and 14% of patients treated with paclitaxel plus carboplatin and veliparib, paclitaxel plus carboplatin, and paclitaxel alone, respectively. The hazard ratio for overall survival was 0.82 with paclitaxel plus carboplatin and veliparib versus paclitaxel alone (P = .452), 1.25 with paclitaxel plus carboplatin and veliparib versus paclitaxel plus carboplatin (P = .455), and 0.63 with paclitaxel plus carboplatin versus paclitaxel alone (P = .166).
Disclosure: For full disclosures of the study authors, visit oncologypro.esmo.org.
