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I-SPY 2 Trial (Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis 2)

Phase 2
18 Years
Open (Enrolling)
Breast Neoplasms, Breast Cancer, Breast Tumors

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Trial Information

I-SPY 2 Trial (Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis 2)

I-SPY 2 will compare the efficacy of novel drugs in combination with standard chemotherapy
with the efficacy of standard therapy alone. The goal is identify improved treatment
regimens for subsets on the basis of molecular characteristics (biomarker signatures) of
their disease. As described for previous adaptive trials, regimens that show a high Bayesian
predictive probability of being more effective than standard therapy will graduate from the
trial with their corresponding biomarker signature(s). Regimens will be dropped if they show
a low probability of improved efficacy with any biomarker signature. New drugs will enter as
those that have undergone testing are graduated or dropped.

Inclusion Criteria:

- Histologically confirmed invasive cancer of the breast

- Clinically or radiologically measureable disease in the breast after diagnostic
biopsy, defined as longest diameter greater than or equal to 25 mm (2.5cm)

- No prior cytotoxic regimens are allowed for this malignancy. Patients may not have
had prior chemotherapy or prior radiation therapy to the ipsilateral breast for this
malignancy. Prior bis-phosphonate therapy is allowed

- Age ≥18 years

- ECOG performance status 0-1

- Willing to undergo core biopsy of the primary breast lesion to assess baseline

- Non-pregnant and non-lactating

- No ferromagnetic prostheses. Patients who have metallic surgical implants that are
not compatible with an MRI machine are not eligible.

- Ability to understand and willingness to sign a written informed consent (I-SPY TRIAL
Screening Consent)

- Eligible tumors must meet one of the following criteria: Stage II or III, or T4, any
N, M0, including clinical or pathologic inflammatory cancer or Regional Stage IV,
where supraclavicular lymph nodes are the only sites metastasis

- Any tumor ER/PgR status, any HER-2/neu status as measured by local hospital pathology
laboratory and meets any tumor assay profile described in protocol section 4.1.2F

- Normal organ and marrow function: Leukocytes ≥ 3000/μL, Absolute neutrophil count ≥
1500/μL, Platelets ≥ 100,000/μL, Total bilirubin within normal institutional limits,
unless patient has Gilbert's disease, for which bilirubin must be ≤ 2.0 x ULN,
AST(SGOT)/ALT (SGPT) ≤ 1.5 x institutional ULN, creatinine < 1.5 x institutional ULN

- No uncontrolled or severe cardiac disease. Baseline ejection fraction (by nuclear
imaging or echocardiography) must by ≥ 50%

- No clinical or imaging evidence of distant metastases by PA and Lateral CXR,
Radionuclide Bone scan, and LFTs including total bilirubin, ALT, AST, and alkaline

- Tumor assay profile must include on of the following: MammaPrint High, any ER status,
any HER2 status, or MammaPrint Low, ER negative (<5%), any HER2 status, or MammaPrint
Low, ER positive, HER2/neu positive by any one of the three methods used (IHC, FISH,

- Ability to understand and willingness to sign a written informed consent document
(I-SPY 2 TRIAL Consent #2)

Exclusion Criteria:

- Use of any other investigational agents within 30 days of starting study treatment

- History of allergic reactions attributed to compounds of similar chemical or biologic
composition to the study agent or accompanying supportive medications.

- Uncontrolled intercurrent illness including, but not limited to, ongoing or active
infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac
arrhythmia, or psychiatric illness/social situations that would limit compliance with
study requirements

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Determine whether adding experimental agents to standard neoadjuvant medications increases the probability of pathologic complete response (pCR) over standard neoadjuvant chemotherapy for each biomarker signature established at trial entry.

Outcome Time Frame:

Post surgery based on upto 24-week treatment

Safety Issue:


Principal Investigator

Laura Esserman, MD, MBA

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of California, San Francisco (UCSF)


United States: Food and Drug Administration

Study ID:




Start Date:

March 2010

Completion Date:

November 2014

Related Keywords:

  • Breast Neoplasms
  • Breast Cancer
  • Breast Tumors
  • I-SPY 2
  • Neoadjuvant
  • Breast
  • Cancer
  • Neoplasm
  • Adaptive
  • pCR
  • Pathologic Complete Response
  • MRV
  • Biomarkers signature
  • MRI
  • Breast Neoplasms
  • Neoplasms



Mayo Clinic Rochester, Minnesota  55905
Swedish Cancer Institute Seattle, Washington  98104
University of Colorado Denver, Colorado  80217
University of California San Diego La Jolla, California  92093
University of Minnesota Minneapolis, Minnesota  55455
University of Washington Seattle, Washington  98195
University of Alabama at Birmingham Birmingham, Alabama  35294-3300
University of Arizona Tucson, Arizona  85724
Emory University Atlanta, Georgia  30322
University of Chicago Chicago, Illinois  60637
Georgetown University Medical Center Washington, District of Columbia  20007
University of Texas, M.D. Anderson Cancer Center Houston, Texas  77030
University of Southern California Los Angeles, California  90033
Loyola University Maywood, Illinois  60153
University of Texas, Southwestern Medical Center Dallas, Texas  75390
Mayo Clinic - Scottsdale Scottsdale, Arizona  85259
University Of Kansas Kansas City, Kansas  66160
University of California San Francisco (UCSF) San Francisco, California  94115
Oregon Health & Science Institute (OHSU) Portland, Oregon  97239
University of Pennsylvania (U Penn) Philadelphia, Pennsylvania  19104
Inova Health System Falls Church, Virginia  22042