The largest radiotherapy clinical trial for breast cancer ever to run in the UK is recruiting patients at The Christie NHS Foundation Trust in Manchester. It aims to cut treatment time for patients receiving a radiotherapy “boost” for breast cancer.
The FAST-Forward Boost trial, led by The Institute of Cancer Research, London and funded by the National Institute for Health and Care Research, will look at whether the full course of treatment, including an additional tumour site “boost” dose, can safely be delivered in just five days, cutting treatment time significantly.
Around 37,000 UK breast cancer patients receive radiotherapy each year to reduce risks of cancer recurrence or spread. Traditionally, treatment has involved 15 daily sessions, with some patients (often younger women) receiving an additional “boost” dose to the tumour site, extending treatment to 23 days.
The FAST-Forward trial, involving over 4,000 patients and 10 years of follow-up, showed that a 5-day schedule is as safe and effective as 15 treatments by using a higher daily dose.
In parallel, another study, called the IMPORT HIGH trial, tested the “simultaneous integrated boost” (SIB) technique, which delivers the boost dose during, rather than after, standard treatment, reducing total treatment time for those needing radiotherapy with a tumour bed boost to 15 days.
The FAST-Forward Boost trial will build on the findings of both these trials by investigating whether the entire course of treatment, including the boost, can be safely delivered in just 5 doses, making the process more convenient for patients, while freeing up vital NHS resources.
The trial is funded by the National Institute for Health and Care Research (NIHR) and led and sponsored by The Institute of Cancer Research (ICR) and The Royal Marsden NHS Foundation Trust in London. More than 40 hospitals in the UK are taking part, with the trial aiming to recruit 4,830 patients over the next 3 years.
Dr Carmel Anandadas, Consultant Oncologist at The Christie and Chief Clinical Co-ordinator for the FAST-Forward Boost trial, said: “Breast cancer survival rates have improved dramatically, and our focus is now also on improving the experience of care. Radiotherapy is highly effective, but it can be time-consuming and disruptive to daily life. We want to find out if we can safely deliver treatment in fewer visits, helping patients recover faster, getting their lives back more quickly, with less impact on work, family and travel.
“By comparing 2 different 5-treatment boost doses with the standard 15 treatment boost dose, we can also identify the 5-treatment boost dose that most closely matches the 15-treatment dose in terms of outcomes.
“The Christie has a long history of pioneering radiotherapy research. This trial is another example of how we’re working to improve not just cancer outcomes, but also quality of life during and after treatment.”
Professor Anna Kirby, Chief Investigator of the FAST-Forward Boost trial, based at The Royal Marsden NHS Foundation Trust and The Institute of Cancer Research, London, said: “We are delighted that The Christie is participating so actively in the FAST-Forward Boost trial.
"By working together with colleagues across the UK, we will be able to deliver this trial promptly with the aim of being able to offer shorter treatment schedules to as many patients as possible needing breast cancer radiotherapy.”
Lucy Jackson is 34 and a mum of 2 young girls from Bolton. She is one of the women who benefitted from having 5 sessions of radiotherapy as part of the trial.
Lucy, who has been married to Callum for nearly 4 years and works in apprenticeships, was diagnosed with breast cancer in April 2025.
“My GP referred me to my local hospital for more tests. I didn’t really think anything of it, so it was quite a shock to be told I had cancer. My girls Annie and Rosie were only 8 and 3 at the time, so my thoughts immediately went to them and Callum.
“It’s important that people advocate for themselves when they go to the doctor. We know our bodies best and shouldn’t be afraid to push for more tests or investigations if we think we need them,” Lucy says.
Lucy’s tumour hadn’t spread and, following a successful operation to remove it, she was referred to The Christie’s local radiotherapy centre in Salford. It was at this point that she was told about the FAST-Forward Boost trial. She started her 5 days of treatment last autumn.
“I agreed to take part straight away,” she says. "I ended up having my radiotherapy over 5 days, which was great. I got no real side effects – I felt a bit tired, and that was it – and it meant I could finish my treatment much quicker,” she says.
“Having fewer sessions also helped me manage day-to-day life better. If the traffic was bad, it could take me about an hour each way to get to Salford, which is time away from Annie and Rosie, so being able to have fewer radiotherapy sessions meant less travel as well.”
Lucy is coming up to the first anniversary of the end of her cancer treatment, and all her recent scans show she is still cancer free.
“I’m the sort of person who just gets on with things, so I didn’t do anything special to celebrate the end of my treatment, but I’m now focussing on my life beyond cancer,” she says. “I’m really glad to have taken part in the trial and have been approached to take part in another study since. I understand how important research is in terms of making things better for cancer patients, and I wanted to do my bit to help others like me in the future,” Lucy adds.
The FAST-Forward Boost trial is recruiting eligible participants at The Christie and other centres until the end of 2028, with results expected in 2033. It is hoped these results will inform future national guidelines on breast cancer treatment. This clinical trial is coordinated by the research centre at The Institute of Cancer Research Clinical Trials and Statistics Unit (ICR-CTSU).
Patients and GPs interested in learning more about the trial are encouraged to contact The Christie or speak with their oncology team.
Not all patients will fit the criteria for a specific trial. While clinical trials can be successful for some patients, outcomes can vary from case to case. More information about taking part in clinical trials can be found on our taking part in studies and trials page.
You can also visit the Be Part of Research website to learn more about research, search for opportunities and sign up to be contacted about studies that interest you.