for people ages 18 years and up (full criteria)
study started
estimated completion
Principal Investigator
by Laura Esserman, MD, MBA (ucsf)
Photo of Laura Esserman
Laura Esserman



The purpose of this study is to further advance the ability to practice personalized medicine by learning which new drug agents are most effective with which types of breast cancer tumors and by learning more about which early indicators of response (tumor analysis prior to surgery via magnetic resonance imaging (MRI) images along with tissue and blood samples) are predictors of treatment success.

Official Title

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


I-SPY 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 complete their evaluation.


Breast Neoplasms Breast Cancer Breast Tumors Angiosarcoma TNBC - Triple-Negative Breast Cancer HER2-positive Breast Cancer HER2-negative Breast Cancer Hormone Receptor Positive Tumor Hormone Receptor Negative Tumor Early-stage Breast Cancer Locally Advanced Breast Cancer Neoadjuvant Breast Cancer Neoplasm Adaptive pCR Pathologic Complete Response Biomarkers signature MRI Volume Endocrine Therapy Chemotherapy Immunotherapy Triple Negative Breast Neoplasms Hemangiosarcoma Metformin Paclitaxel Ado-Trastuzumab Emtansine Albumin-Bound Paclitaxel Carboplatin Doxorubicin Pembrolizumab Trastuzumab Irinotecan Durvalumab Letrozole Olaparib Pertuzumab Veliparib Talazoparib Cemiplimab Trebananib Tucatinib AMG 386 with or without Trastuzumab AMG 479 (Ganitumab) plus Metformin MK-2206 with or without Trastuzumab AMG 386 and Trastuzumab T-DM1 and Pertuzumab Pertuzumab and Trastuzumab Ganetespib ABT-888 Neratinib PLX3397 Pembrolizumab - 4 cycle Talazoparib plus Irinotecan Patritumab and Trastuzumab Pembrolizumab - 8 cycle SGN-LIV1A Durvalumab plus Olaparib SD-101 + Pembrolizumab Tucatinib plus trastuzumab and pertuzumab Cemiplimab plus REGN3767 Trilaciclib with or without trastuzumab + pertuzumab SYD985 ([vic-]trastuzumab duocarmazine) Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab Amcenestrant Amcenestrant + Abemaciclib Amcenestrant + Letrozole AMG 479 plus Metformin Pembrolizumab 4 cycle Pembrolizumab 8 cycle Endocrine Optimization Pilot: Amcenestrant Monotherapy Endocrine Optimization Pilot: Amcenestrant + Abemaciclib Endocrine Optimization Pilot: Amcenestrant + Letrozole


You can join if…

Open to people ages 18 years and up

  • 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 biomarkers
  • 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 phosphatase
  • 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, TargetPrint™)
  • Ability to understand and willingness to sign a written informed consent document (I-SPY 2 TRIAL Consent #2)

You CAN'T join if...

  • 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


  • University of California San Diego accepting new patients
    La Jolla California 92093-0698 United States
  • University of California San Francisco (UCSF) accepting new patients
    San Francisco California 94115 United States

Lead Scientist at University of California Health


accepting new patients
Start Date
Completion Date
QuantumLeap Healthcare Collaborative
Abstract S5-02 SABCC 2014 Abstract CT227 AACR 2014 Abstract P1-14-03; SABCC 2015
Phase 2
Study Type
Last Updated