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FAST-Forward: A clinical trial testing a one week schedule of whole breast radiotherapy against a three week schedule

In follow-up

What is the study about?  

FAST-Forward is investigating whether a shorter course of radiotherapy treatment for people with breast cancer is as safe and effective as the standard longer course.

When FAST-Forward started all participants received radiotherapy treatment targeted at their breast alone. In 2015 the study was modified to allow participants to receive radiotherapy both to their breast and to nearby lymph nodes which were affected by cancer.

Who is included in the study?

FAST-Forward included people with breast cancer who were receiving radiotherapy after surgery to remove their cancer.

  • 4,100 people who were having radiotherapy targeted at their breast joined the main study.
  • 469 people who were having treatment targeted at their breast and nearby lymph nodes joined the nodal substudy.

People from 102 NHS hospitals across the UK joined the trial.

What are the study treatments?

The FAST-Forward study included three treatment groups:

  • Standard treatment - fifteen daily doses of radiotherapy over three weeks
  • Test group one - five daily doses of radiotherapy over one week
  • Test group two - five daily doses of radiotherapy over one week, at a slightly lower daily dose than test group one

Participants have regular check-ups during and after their treatment and we collect information about how they are getting on until the study is completed.

Contact details and regulatory information

Chief Investigator: Professor Murray Brunt, University of Keele and Institute of Cancer Research

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)

Trial identifiers

REC reference: 11/LO/0958

CPMS ID: 10896


Publications and presentations

Brunt AM, Haviland JS, Wheatley DA, Sydenham MA, Alhasso A, Bloomfield DJ, Chan C, Churn M, Cleator S, Coles CE, Goodman A, Harnett A, Hopwood P, Kirby A, Kirwan C, Morris C, Nabi Z, Sawyer E, Somaiah N, Stones L, Syndikus I, Bliss JM and Yarnold JR, on behalf of the FAST-Forward Trial Management Group. 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, May 2020

Brunt AM, Wheatley D, Yarnold JR, Somaiah N, Kelly S, Harnett A, Coles CE, Goodman A, Bahl A, Churn M, Zotova R, Sydenham MA, Griffin CL, Morden J and Bliss JM, on behalf of the FAST-Forward Trial Management Group. 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, Radiotherapy and Oncology, July 2016

Brunt AM, Yarnold J, Wheatley D, Somaiah N, Kelly S, Harnett A, Coles C, Goodman A, Zotova R, Sydenham M, Griffin C and 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

Clinical trials

Division of Clinical Studies

The division carries out or coordinates high-quality trials and translational research at both an early phase – typically to test new targeted drugs – and a later stage.