Randomised clinical trial testing a 1 week course of curative whole breast radiotherapy against a standard 3 week schedule in terms of local cancer control and late adverse effects in patients with early breast cancer.
Disease site: Breast cancer
Treatment modality: Radiotherapy
Status: In follow-up
Protocol and planning packs
FAST-Forward is a phase III, multicentre, randomised controlled trial that aims to identify a 1 week, 5 fraction schedule of curative radiotherapy that is at least as effective and safe as the current UK standard 15 fraction regimen used after primary surgery for early breast cancer.
4,100 patients were recruited from UK sites over a 2.5 year period. Patients received daily fractions of radiotherapy to the whole breast or post mastectomy chest wall/reconstructed breast for either 5 or 15 days. Each participant was allocated to one of the following groups:
- Control group: 40.05 Gy in 15 Fr of 2.67 Gy
- Test group 1: 27.0 Gy in 5 Fr of 5.4 Gy
- Test group 2: 26.0 Gy in 5 Fr of 5.2 Gy
A further sub-study opened to recruitment in February 2016. An additional 627 patients receiving lymphatic radiotherapy in addition to whole breast radiotherapy will be recruited from the existing centres.
Participants will be followed up for 10 years following completion of radiotherapy.
Chief Investigator: Professor Murray Brunt, University Hospital of North Midlands NHS Trust and Keele University
ICR-CTSU Scientific Lead: Professor Judith Bliss
Trial management contact: [email protected]
Sponsor: The Institute of Cancer Research
Funding: National Institute for Health Research – Health Technology Assessment Programme (Grant 09/01/1947)
Further information including recruitment progress is available from the following link:
UK Clinical Trials Gateway
Patient friendly information is available from the following link:
Results of the FAST-Forward trial – lay summary
Publications and presentations
Brunt, A.M., Haviland, J.S., Wheatley, D.A., Sydenham, M.A., Alhasso, A., Bloomfield, D.J., Chan, C., Churn, M., Cleator, S., Coles, C.E., Goodman, A., Harnett, A., Hopwood, P., Kirby, A., Kirwan, C., Morris, C., Nabi Z., Sawyer, E., Somaiah, N., Stones, L., Syndikus, I., Bliss, J.M. and Yarnold, J.R., on behalf of the FAST-Forward Trialists. Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 5-year efficacy and late normal tissue effects results from a multicentre, non-inferiority, randomised, phase 3 trial. The Lancet published on-line 28th April 2020
A.M. Brunt, D. Wheatley, J.R. Yarnold, N. Somaiah, S. Kelly, A. Harnett, C.E. Coles, A. Goodman, A. Bahl, M. Churn, R. Zotova, M.A. Sydenham, C.L. Griffin, J. Morden, J.M. Bliss. Acute skin toxicity associated with a 1-week schedule of whole breast radiotherapy compared with a standard 3-week regimen delivered in the UK FAST-Forward Trial. Radiother Oncol 2016 Jul:120(1): 114–118. Epub 2016 Apr 1.
Brunt AM, Yarnold J, Wheatley D, Somaiah N, Kelly S, Harnett A, Coles C, Goodman A, Zotova R, Sydenham M, Griffin C, Bliss J. Acute skin toxicity reported in the FAST-Forward trial (HTA 09/01/47): a phase III randomised trial of 1-week whole breast radiotherapy compared to standard 3 weeks in patients with early breast cancer. Presented at: 10th National Cancer Research Institute Cancer Conference; 2014 Nov 2-5; Liverpool, UK.