I-SPY 2: a Neoadjuvant Adaptive Clinical Trial Designed to Improve Outcomes in High-Risk Breast Cancer

Haiyun Wang, Douglas Yee

Research output: Contribution to journalReview articlepeer-review


Purpose of Review: The I-SPY 2 trial is an adaptive clinical trial platform designed to improve outcomes in high-risk breast cancer patients by testing new drugs in the neoadjuvant setting. The intent of this review is to discuss background, study structure, innovation, and outcomes of the I-SPY 2 trial. Recent Findings: I-SPY 2 evaluates new agents combined with standard therapy with pathologic complete response (pCR) as the primary endpoint. I-SPY-2 uses clinical biomarkers to classify breast cancer into 10 subtypes, with Bayesian adaptive randomization to allow individualized patient assignment to therapy arms to maximize treatment effects. A total of 7 drugs have graduated from I-SPY 2. Multiple new agents are currently in active enrollment in I-SPY 2. Summary: I-SPY 2 uses an individualized approach in clinical trial design to improve high-risk breast cancer outcomes. The purpose of this review is to encourage further research and innovation in this area and bring more precise treatment options to breast cancer patients.

Original languageEnglish (US)
Pages (from-to)303-310
Number of pages8
JournalCurrent Breast Cancer Reports
Issue number4
StatePublished - Dec 1 2019

Bibliographical note

Funding Information:
Douglas Yee reports grants from QuantumLeap, grants from the National Cancer Institute (P30-CA077598), and grants from the National Cancer Institute (P01 CA210961) during the conduct of the study. Dr. Yee also reports personal fees from AstraZeneca and Puma outside the submitted work. Haiyun Wang declares no conflicts of interest relevant to this manuscript.


  • Adaptive randomization
  • Breast cancer
  • I-SPY 2
  • Neoadjuvant chemotherapy
  • Pathological complete response

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