I-SPY TRIAL: Neoadjuvant and Personalized Adaptive Novel Agents to Treat Breast Cancer (I-SPY)
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The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. |
ClinicalTrials.gov Identifier: NCT01042379 |
Recruitment Status :
Recruiting
First Posted : January 5, 2010
Last Update Posted : March 24, 2023
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Condition or disease | Intervention/treatment | Phase |
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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 | Drug: Standard Therapy Drug: AMG 386 with or without Trastuzumab Drug: AMG 479 (Ganitumab) plus Metformin Drug: MK-2206 with or without Trastuzumab Drug: AMG 386 and Trastuzumab Drug: T-DM1 and Pertuzumab Drug: Pertuzumab and Trastuzumab Drug: Ganetespib Drug: ABT-888 Drug: Neratinib Drug: PLX3397 Drug: Pembrolizumab - 4 cycle Drug: Talazoparib plus Irinotecan Drug: Patritumab and Trastuzumab Drug: Pembrolizumab - 8 cycle Drug: SGN-LIV1A Drug: Durvalumab plus Olaparib Drug: SD-101 + Pembrolizumab Drug: Tucatinib plus trastuzumab and pertuzumab Drug: Cemiplimab Drug: Cemiplimab plus REGN3767 Drug: Trilaciclib with or without trastuzumab + pertuzumab Drug: SYD985 ([vic-]trastuzumab duocarmazine) Drug: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab Drug: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab Drug: Amcenestrant Drug: Amcenestrant + Abemaciclib Drug: Amcenestrant + Letrozole Drug: ARX788 Drug: ARX788 + Cemiplimab Drug: VV1 + Cemiplimab Drug: Datopotamab deruxtecan Drug: Datopotamab deruxtecan + Durvalumab Drug: Zanidatamab Drug: Lasofoxifene Drug: Z-endoxifen | Phase 2 |
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 5000 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | I-SPY Trial (Investigation of Serial Studies to Predict Your Therapeutic Response With Imaging And moLecular Analysis 2) |
Actual Study Start Date : | March 1, 2010 |
Estimated Primary Completion Date : | December 2030 |
Estimated Study Completion Date : | December 2031 |

Arm | Intervention/treatment |
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Active Comparator: Standard Therapy
Paclitaxel, Herceptin followed by Doxorubicin and Cyclophosphamide treatment depending on HR/HER-2 status.
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Drug: Standard Therapy
Paclitaxel: 80 mg/m2 IV during the 12 weekly treatment cycles post randomization; Doxorubicin: 60 mg/m2 IV after completion of the 12 weekly treatment cycles and prior to surgery for weeks 13-16; Cyclophosphamide: 600 mg/m2 IV after completion of the 12 weekly treatment cycles and prior to surgery for weeks 13-16
Other Name: Paclitaxel (Taxol); Doxorubicin (Adriamycin) |
Experimental: AMG 386 with or without Trastuzumab
Arm is closed.
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Drug: AMG 386 with or without Trastuzumab
Arm is closed.
Other Name: AMG 386 (Trebananib); (Trastuzumab) Herceptin Drug: AMG 386 and Trastuzumab Arm is closed.
Other Name: AMG 386 (Trebananib); Trastuzumab (Herceptin) |
AMG 479 plus Metformin
Arm is closed.
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Drug: AMG 479 (Ganitumab) plus Metformin
Arm is closed.
Other Name: Ganitumab |
Experimental: MK-2206 with or without Trastuzumab
Arm is closed.
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Drug: MK-2206 with or without Trastuzumab
Arm is closed.
Other Name: (Trastuzumab) Herceptin |
Experimental: T-DM1 and Pertuzumab
Arm is closed.
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Drug: T-DM1 and Pertuzumab
Arm is closed.
Other Name: T-DM1 (Trastuzumab emtansine); Pertuzumab (Perjeta) |
Active Comparator: Pertuzumab and Trastuzumab
Novel Control Investigational Agent. Arm is closed.
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Drug: Pertuzumab and Trastuzumab
Pertuzumab: 840 mg IV (loading dose) week 1 and 420 mg every 3 weeks (weeks 4, 7, 10) post-randomization; Trastuzumab: 4 mg/kg (loading dose) week 1 and 2 mg/kg weekly (weeks 2-12) post-randomization
Other Name: Pertuzumab (Perjeta); Trastuzumab (Herceptin) |
Experimental: Ganetespib
Arm is closed.
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Drug: Ganetespib
Arm is closed. |
ABT-888
Arm is closed.
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Drug: ABT-888
Arm is closed.
Other Name: Veliparib |
Neratinib
Arm is closed.
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Drug: Neratinib
Arm is closed. |
Experimental: PLX3397
Arm is closed.
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Drug: PLX3397
Arm is closed. |
Experimental: Pembrolizumab 4 cycle
Arm is closed.
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Drug: Pembrolizumab - 4 cycle
Arm is closed. |
Experimental: Talazoparib plus Irinotecan
Arm is closed.
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Drug: Talazoparib plus Irinotecan
Arm is closed. |
Experimental: Patritumab with or without Trastuzumab
Arm is closed.
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Drug: Patritumab and Trastuzumab
Arm is closed. |
Experimental: Pembrolizumab 8 cycle
Arm is closed.
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Drug: Pembrolizumab - 8 cycle
Arm is closed. |
Experimental: SGN-LIV1A
Arm is closed.
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Drug: SGN-LIV1A
Arm is closed. SGN-LIV1A: 2.5 mg/kg IV cycles 1,4,7,10 Doxorubicin + Cyclophosphamide: Cycles 13-16 |
Experimental: Durvalumab plus Olaparib
Arm is closed.
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Drug: Durvalumab plus Olaparib
Arm is closed. |
Experimental: SD-101 + Pembrolizumab
Arm is closed.
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Drug: SD-101 + Pembrolizumab
Arm is closed. SD-101: IT injection 2 mg/ml (1 ml for T2 tumors, 2 ml for >T3 tumors) weekly x 4, then every 3 weeks x 2 cycles 1,2,3,4,7,10 Pembrolizumab: 200mg IV cycles 1,4,7,10 Paclitaxel: 80 mg/m2 IV cycles 1-12 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles |
Experimental: Tucatinib
Arm is closed.
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Drug: Tucatinib plus trastuzumab and pertuzumab
Arm is closed. Tucatinib: 300 mg PO BID 12 weeks CLOSED Tucatinib: 250 mg PO BID 12 weeks CLOSED Tucatinib adaptive: 150mg BID days 1-28, 250mg BID days 29-84 Trastuzumab: 4 mg/kg IV (loading dose) cycle 1; 2 mg/kg (thereafter) cycles 2-12 Pertuzumab: 840 mg IV (loading dose) cycle 1; 420 mg (thereafter) cycles 4, 7 and 10 Paclitaxel: 80 mg/m2 IV cycles 1-12 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles |
Experimental: Cemiplimab
Novel Investigational Agent. Arm is closed.
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Drug: Cemiplimab
Cemiplimab: 350 mg q3w X 12 weeks IV cycles 1,4,7,10 Paclitaxel: 80 mg/m2 IV cycles 1-12 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles |
Experimental: Cemiplimab plus REGN3767
Novel Investigational Agent. Arm is closed.
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Drug: Cemiplimab plus REGN3767
Cemiplimab: 350 mg q3w X 12 weeks IV cycles 1,4,7,10 REGN 3767: 1600 mg q3W X 12 weeks IV cycles 1,4,7,10 Paclitaxel: 80 mg/m2 IV cycles 1-12 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles |
Experimental: Trilaciclib with or without trastuzumab + pertuzumab
Novel Investigational Agent. Arm is closed.
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Drug: Trilaciclib with or without trastuzumab + pertuzumab
Trilaciclib: 240 mg/m2 IV weekly cycle 1-16 Paclitaxel: 80 mg/m2 IV cycles 1-12 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles For HER2+: Pertuzumab: 840 mg IV (loading dose) week 1 and 420 mg every 3 weeks (weeks 4, 7, 10) post-randomization Trastuzumab: 4 mg/kg (loading dose) week 1 and 2 mg/kg weekly (weeks 2-12) post-randomization Other Name: Trilaciclib (G1T28); Pertuzumab (Perjeta); Trastuzumab (Herceptin) |
Experimental: SYD985 ([vic-]trastuzumab duocarmazine)
Novel Investigational Agent. Arm is closed.
|
Drug: SYD985 ([vic-]trastuzumab duocarmazine)
SYD985: 1.2 mg/kg IV (q3w x 12 weeks) cycles 1,4,7,10 Doxorubicin + Cyclophosphamide: Cycles 13-16; Doxorubicin: 60 mg/m2 IV Every 2 or 3 weeks for 4 cycles; Cyclophosphamide: 600 mg/m2 IV Every 2 or 3 weeks for 4 cycles |
Experimental: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab
Novel Investigational Agent. Arm is closed.
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Drug: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) + Carboplatin with or without trastuzumab
For HER2+ Dostarlimab (TSR-042), 500 mg, IV, q3wks for wk 1, 4, 7, 10 Trastuzumab, 4 mg/kg cycle 1, then 2 mg/kg cycles 2-12 q1wk, IV, for wk1-12 Oral paclitaxel, 205 mg/m2, oral, daily for Three (3) days in a row each week for weeks 1-12 Oral encequidar, 15 mg, oral, daily for Three (3) days in a row each week for weeks 1-12 Carboplatin, AUC 1.5, IV, q1wk from wk1-12 Followed by Doxorubicin: 60 mg/m2, IV, every 2 or 3 weeks for 4 cycles Cyclophosphamide: 600 mg/m2, IV, every 2 or 3 weeks for 4 cycle For HER2- Dostarlimab (TSR-042), 500 mg, IV, q3wks for wk 1, 4, 7, 10 Oral paclitaxel, 205 mg/m2, oral, daily for Three (3) days in a row each week for weeks 1-12 Oral encequidar, 15 mg, oral, daily for Three (3) days in a row each week for weeks 1-12 Carboplatin, AUC 1.5, IV, q1wk from wk1-12 Followed by Doxorubicin: 60 mg/m2, IV, every 2 or 3 weeks for 4 cycles Cyclophosphamide: 600 mg/m2, IV, every 2 or 3 weeks for 4 cycle Other Name: Oral Paclitaxel + Encequidar (Oraxol); Dostarlimab (TSR-042); Trastuzumab (Herceptin) |
Experimental: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab
Novel Investigational Agent. Arm is closed.
|
Drug: Oral Paclitaxel + Encequidar + Dostarlimab (TSR-042) with or without trastuzumab
For HER2+ Dostarlimab (TSR-042), 500 mg, IV, q3wks for wk 1, 4, 7, 10 Trastuzumab, 4 mg/kg cycle 1, then 2 mg/kg cycles 2-12 q1wk, IV, for wk1-12 Oral paclitaxel, 205 mg/m2, oral, daily for Three (3) days in a row each week for weeks 1-12 Oral encequidar, 15 mg, oral, daily for Three (3) days in a row each week for weeks 1-12 Followed by Doxorubicin: 60 mg/m2, IV, every 2 or 3 weeks for 4 cycles Cyclophosphamide: 600 mg/m2, IV, every 2 or 3 weeks for 4 cycle For HER2- Dostarlimab (TSR-042), 500 mg, IV, q3wks for wk 1, 4, 7, 10 Oral paclitaxel, 205 mg/m2, oral, daily for Three (3) days in a row each week for weeks 1-12 Oral encequidar, 15 mg, oral, daily for Three (3) days in a row each week for weeks 1-12 Followed by Doxorubicin: 60 mg/m2, IV, every 2 or 3 weeks for 4 cycles Cyclophosphamide: 600 mg/m2, IV, every 2 or 3 weeks for 4 cycle Other Name: Oral Paclitaxel + Encequidar (Oraxol); Dostarlimab (TSR-042); Trastuzumab (Herceptin) |
Experimental: Endocrine Optimization Pilot: Amcenestrant Monotherapy
Novel Investigational Agent. Arm is closed.
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Drug: Amcenestrant
Amcenestrant (SAR439859), 200mg QD, p.o., for 24 weeks
Other Name: SAR439859 |
Experimental: Endocrine Optimization Pilot: Amcenestrant + Abemaciclib
Novel Investigational Agent. Arm is closed.
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Drug: Amcenestrant + Abemaciclib
Amcenestrant (SAR439859), 200mg QD, p.o., for 24 weeks Abemaciclib (Verzenio), 150mg BID, p.o., for 24 weeks
Other Name: Amcenestrant (SAR439859), Abemaciclib (Verzenio) |
Experimental: Endocrine Optimization Pilot: Amcenestrant + Letrozole
Novel Investigational Agent. Arm is closed.
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Drug: Amcenestrant + Letrozole
Amcenestrant (SAR439859), 200mg QD, p.o., for 24 weeks Letrozole (Femara), 2.5mg QD, p.o., for 24 weeks
Other Name: Amcenestrant (SAR439859), Letrozole (Femara) |
Experimental: ARX788 in Block A and followed by SOC in Block B
Novel investigational Agent followed by SOC
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Drug: ARX788
ARX788, 1.5 mg/kg Q3W, IV for 12 weeks |
Experimental: ARX788 + Cemiplimab in Block A and followed by SOC in Block B
Novel investigational Agent followed by SOC. Arm is closed.
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Drug: ARX788 + Cemiplimab
ARX788, 1.5 mg/kg Q3W, IV for 12 weeks Cemiplimab, 350 mg Q3W, IV for 12 weeks |
Experimental: VSV-IFNβ-NIS (VOYAGER V1™; VV1) + Cemiplimab in Block A and followed by SOC in block B
Novel investigational Agent followed by SOC
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Drug: VV1 + Cemiplimab
VV1, 3x10^9 TCID50 once (day-8), Intra-tumoral injection Cemiplimab, 350 mg Q3W, IV for 12 weeks
Other Names:
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Experimental: Datopotamab Deruxtecan in Block A and followed by SOC in block B
Novel investigational Agent followed by SOC
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Drug: Datopotamab deruxtecan
Dato-DXd, 6 mg/kg Q3W, IV for 12 weeks
Other Name: Dato-DXd |
Experimental: Datopotamab Deruxtecan + Durvalumab in Block A and followed by SOC in block B
Novel investigational Agent followed by SOC
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Drug: Datopotamab deruxtecan + Durvalumab
Dato-DXd, 6 mg/kg Q3W, IV for 12 weeks Durvalumab, 1120 mg Q3W, IV for 12 weeks
Other Name: Dato-DXd |
Experimental: Zanidatamab in Block A and followed by SOC in block B
Novel investigational Agent followed by SOC
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Drug: Zanidatamab
Zanidatamab: Flat dose of 1,200mg Q2W for 12 weeks |
Experimental: Endocrine Optimization Pilot: Lasofoxifene
Novel investigational Agent
|
Drug: Lasofoxifene
Lasofoxifene: 5.0 mg QD, p.o., for 24 weeks |
Experimental: Endocrine Optimization Pilot: (Z)-Endoxifen
Novel investigational Agent
|
Drug: Z-endoxifen
Z-endoxifen: 10 mg QD, p.o., for 24 weeks |
- 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. [ Time Frame: Post surgery based on upto 36-week treatment ]
- Establishing predictive and prognostic indices based on qualification and exploratory markers to predict pCR and residual cancer burden (RCB). [ Time Frame: Blood and Tissue Collection: Baseline, Post-Randomization, Pre-AC, Pre- and Post-Surgery ]
- To determine three- and five-year relapse-free survival (RFS) and OS among the treatment arms. [ Time Frame: Three- and Five-Year Post-surgery Follow-up ]
- To determine incidence of adverse events (AEs), serious adverse events (SAEs), and laboratory abnormalities of each investigational agent tested. [ Time Frame: Post-Randomization, Pre-AC, Pre-Surgery, Post-Surgery upto One Year during follow-up ]
- MRI Volume [ Time Frame: Four time points during the on-study phase: Baseline, Post-randomization, Pre-AC treatment and Pre-Surgery ]

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
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 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)
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

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01042379
Contact: Won Chang | (855) 866-0505 | w.chang@quantumleaphealth.org | |
Contact: Maria Pitsiouni, PhD | m.pitsiouni@quantumleaphealth.org |

Principal Investigator: | Laura Esserman, MD, MBA | University of California, San Francisco |
Publications of Results:
Other Publications:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | QuantumLeap Healthcare Collaborative |
ClinicalTrials.gov Identifier: | NCT01042379 |
Other Study ID Numbers: |
097517 |
First Posted: | January 5, 2010 Key Record Dates |
Last Update Posted: | March 24, 2023 |
Last Verified: | March 2023 |
Neoadjuvant Breast Cancer Neoplasm Adaptive pCR |
Pathologic Complete Response Biomarkers signature MRI Volume Endocrine Therapy Chemotherapy Immunotherapy |
Breast Neoplasms Triple Negative Breast Neoplasms Hemangiosarcoma Neoplasms Neoplasms by Site Breast Diseases Skin Diseases Sarcoma Neoplasms, Connective and Soft Tissue Neoplasms by Histologic Type Neoplasms, Vascular Tissue Metformin Paclitaxel Ado-Trastuzumab Emtansine Albumin-Bound Paclitaxel |
Carboplatin Doxorubicin Pembrolizumab Trastuzumab Irinotecan Durvalumab Letrozole Olaparib Pertuzumab Veliparib Cemiplimab Talazoparib Dostarlimab Trebananib Tucatinib |