IMpassion130
In first-line advanced TNBC, does atezolizumab plus nab-paclitaxel improve outcomes versus nab-paclitaxel alone?
Trial design and population
Key results
Median PFS in ITT was 7.2 vs 5.5 months (HR 0.80); in PD-L1-positive disease it was 7.5 vs 5.0 months (HR 0.62). Updated median OS was 21.0 vs 18.7 months in ITT (HR 0.86, 95% CI 0.72–1.02; P=.078); in PD-L1-positive disease, 25.0 vs 18.0 months (HR 0.71), but formal OS testing was precluded by the statistical hierarchy.
Source-reported outcome visualization
Median PFS (PD-L1-positive) · Median
Bars are scaled to the larger reported group value; endpoint, unit and horizon are labelled. Values are source-reported, not estimated from medians.
Absolute Effect
Median PFS difference in PD-L1-positive subgroup was 2.5 months; not an NNT. PD-L1-positive OS signal was not formally confirmatory under the prespecified testing hierarchy.
NNT: Not calculated; median endpoints and hierarchical OS limitation. Use only at the stated endpoint/time horizon; median survival differences are not converted into NNT.
NNH: Not quantifiable. Grade 3–4 neutropenia about 8%, peripheral neuropathy about 6% vs 3%; rare treatment-related deaths occurred in both groups. Nab-paclitaxel toxicity and immune-mediated events require monitoring.
Time-to-event hazard ratios and median survival are not treated as absolute risk differences. Where no defensible fixed-time NNT/NNH is available, the source-reported endpoint is visualized instead.
Safety and treatment burden
Grade 3–4 neutropenia about 8%, peripheral neuropathy about 6% vs 3%; rare treatment-related deaths occurred in both groups. Nab-paclitaxel toxicity and immune-mediated events require monitoring.
Follow-up, maturity and limitations
Follow-up: Updated OS analysis median follow-up approximately 18 months.
ITT OS did not cross the prespecified significance boundary, so the PD-L1-positive OS finding was not formally tested. Regulatory status varies by jurisdiction.
Clinical interpretation
Current-practice context · reviewed 20 October 2026
This page separates the original trial findings from contemporary treatment sequencing. Confirm current guidelines, local regulatory status, biomarker requirements, prior treatment exposure and patient-specific contraindications before applying the evidence. Historical comparators may no longer represent the current standard; subgroup findings and immature endpoints are labelled rather than generalized.