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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

Trial details

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.

To learn and understand more about your diagnosis, and the care and treatment you receive, we have asked your permission to access information in your NHS medical records about your health conditions, treatment, progress, and (in the event of your passing away for whatever reason) mortality information.

To do this your NHS number and date of birth was securely shared by the PHE National Cancer Registration and Analysis Service (NCRAS) to allow your records to be located. Data supplied by NCRAS will relate to your cancer and care over time, and will be linked to the information obtained from your hospital as part of the trial. All the information shared with  NCRAS will be governed by strict rules covering data protection and confidentiality. You can find out more about how we will protect your information in our research privacy notice.

Further information for potential participants

Patient Information Sheet

Patient Information Sheet (lymphatic sub-study)

Patient Information Sheet (no PROMS or photos)

Patient Information Sheet (short term side effects)

Further information for healthcare professionals


Further information

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]

ISRCTN: 19906132

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 on the FAST-Forward page on the National Institute for Health Research website: NIHR - Be Part Of Research.

Patient friendly information is available on CancerHelp UK

Lay summary

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 online 28 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.

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.