Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute and Honorary Professor of Medicine at Cardiff University School of Medicine, shared a post on LinkedIn:
“Landmark 10-Year Data Confirms 1-Week Radiotherapy as Standard of Care in Early Breast Cancer
The FAST-Forward trial, published in The Lancet Oncology, has just reported its highly anticipated 10-year outcomes – and the results are practice-changing.
This phase 3 RCT of over 4,000 patients confirms that 26 Gy in five fractions over just one week is as safe and effective as the traditional 3-week schedule (40 Gy in 15 fractions), with:
- 10-year ipsilateral breast recurrence of only 2.1% (vs 3.6% with 40 Gy)
- Comparable normal tissue effects at 10 years
- Reassuring locoregional control data for patients requiring axillary radiotherapy
- Confirmed cost-effectiveness over the long term
The nodal substudy also provides encouraging efficacy data for axillary radiotherapy with this schedule, supporting its use with appropriate shared decision-making.
This is a major step forward for our patients – reducing the burden of treatment without compromising outcomes. Shorter radiotherapy means fewer hospital visits, less disruption to daily life, and a more sustainable healthcare system.
The evidence now firmly supports 26 Gy in five fractions as the international standard of care for adjuvant radiotherapy to the breast or chest wall in early breast cancer. For those countries yet to adopt it, the time to act is now.”
Title: Hypofractionated breast radiotherapy for 1 week versus 3 weeks (FAST-Forward): 10-year efficacy and late normal tissue effects from a multicentre, open-label, non-inferiority, phase 3, randomised controlled trial and 5-year efficacy results from a randomised axillary substudy
Authors: Adrian Murray Brunt, Fay H. Cafferty, Anna M. Kirby, Jaymini Patel, Mark A. Sydenham, Joanne S. Haviland, Susan Griffin, Carlos Chivardi, Helen Fleming, Charlotte E. Coles, David J. Bloomfield, Charlie Chan, Susan Cleator, Andy Goodman, Clare L. Griffin, Cliona C. Kirwan, Zohal Nabi, Elinor Sawyer, Navita Somaiah, Isabel Syndikus, Karen Venables, Duncan A. Wheatley, John R. Yarnold, Judith M. Bliss
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