{"entity":{"id":"fast-forward","kind":"trial","name":"FAST-Forward","aka":[],"tldr":"FAST-Forward cut breast radiotherapy to five treatments in a single week and showed the same low relapse rate as the three-week standard, with similar late effects at five years.","summary":"FAST-Forward randomised 4,096 women with early breast cancer to 40 Gy in 15 fractions, 27 Gy in five or 26 Gy in five fractions over one week. Five-year ipsilateral breast tumour relapse was 2.1 percent after 40 Gy and 1.4 percent after 26 Gy, meeting the non-inferiority margin; late normal-tissue effects after 26 Gy were similar to the standard arm while 27 Gy gave more (Murray Brunt and colleagues, Lancet 2020). One-week radiotherapy became standard in the UK and, accelerated by the pandemic, widely elsewhere.","status":"positive","asOf":"2026-09-16","links":[{"label":"ISRCTN19906132","url":"https://www.isrctn.com/ISRCTN19906132"},{"label":"Lancet 2020","url":"https://doi.org/10.1016/S0140-6736(20)30932-6"}],"tags":["radiation-wave2"],"related":[],"cancers":["breast-hr-positive","breast-her2-positive","tnbc"],"sections":[],"technologies":["hypofractionated-radiotherapy","imrt-igrt"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["hypofractionation"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"notes":[],"phase":"3","setting":"Early breast cancer after surgery: 26 Gy in five fractions over one week versus 40 Gy in 15 fractions over three weeks","sponsor":"Institute of Cancer Research (UK)","result":"5-year ipsilateral breast tumour relapse 1.4% (26 Gy in 5) vs 2.1% (40 Gy in 15), non-inferior.","yearReported":2020,"enrolled":4096,"outcomes":[{"endpoint":"Ipsilateral breast tumour relapse at 5 years","primary":true,"unit":"%","arms":[{"name":"26 Gy in 5 fractions","n":1368,"value":1.4},{"name":"40 Gy in 15 fractions","n":1361,"value":2.1}]}]},"route":"/trials/fast-forward/","neighbours":{"cancer":[{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"}],"term":[{"id":"hypofractionation","kind":"term","name":"Hypofractionation (fewer, larger radiotherapy doses)","route":"/terms/hypofractionation/"}]}}