I-SPY 2 — Toward More Rapid Progress in Breast Cancer Treatment

Clinical trials of systemic therapy for operable breast cancer are evolving. Our understanding of breast cancer as a family of biologically distinct diseases has implications for patient selection and the optimization of drug choices. In addition, there is a growing dissatisfaction with trials of adjuvant therapy that are large, take many years to complete, and often result in very small improvements in outcome. For these reasons, we must be thoughtful and rigorous in focusing the testing of promising agents in patients who could derive a meaningful benefit. These realities are in part responsible for the explosion of “neoadjuvant,” or preoperative, . . .