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Professor Adrian Brunt's Outputs (44)

Partial-breast radiotherapy after breast conservation surgery for women with early breast cancer (UK IMPORT LOW): 10-year outcomes from a multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial. (2025)
Journal Article
Kirby, A. M., Finneran, L., Griffin, C. L., Brunt, A. M., Cafferty, F. H., Alhasso, A., Chan, C., Haviland, J. S., Jefford, M. L., Sawyer, E. J., Sydenham, M. A., Syndikus, I., Tsang, Y. M., Wheatley, D., Yarnold, J. R., Coles, C. E., & Bliss, J. M. (2025). Partial-breast radiotherapy after breast conservation surgery for women with early breast cancer (UK IMPORT LOW): 10-year outcomes from a multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial. The Lancet Oncology, 26(7), 898-910. https://doi.org/10.1016/S1470-2045%2825%2900194-9

The IMPORT LOW trial evaluated partial-breast radiotherapy with intensity-modulated radiotherapy in women with early-stage breast cancer at below average risk of ipsilateral breast tumour recurrence (IBTR). 5-year results concluded non-inferiority of... Read More about Partial-breast radiotherapy after breast conservation surgery for women with early breast cancer (UK IMPORT LOW): 10-year outcomes from a multicentre, open-label, randomised, controlled, phase 3, non-inferiority trial..

Patient- and clinician-assessed five-year normal tissue effects following one-week versus three-week axillary radiotherapy for breast cancer: Results from the phase III FAST-Forward trial randomised nodal sub-study. (2025)
Journal Article
Brunt, A. M., Cafferty, F. H., Wheatley, D., Sydenham, M. A., Kirby, A. M., Coles, C. E., Patel, J., Alhasso, A., Chan, C., Cleator, S., Fleming, H., Gahir, D., Goodman, A., Griffin, C., Haviland, J. S., Kirwan, C., Nabi, Z., Poole, K., Sawyer, E., Sinclair, J., …Bliss, J. M. (in press). Patient- and clinician-assessed five-year normal tissue effects following one-week versus three-week axillary radiotherapy for breast cancer: Results from the phase III FAST-Forward trial randomised nodal sub-study. Radiotherapy and Oncology, 207, Article 110915. https://doi.org/10.1016/j.radonc.2025.110915

FAST-Forward showed that 26 Gray (Gy) in 5 fractions (Fr) over one week adjuvant radiotherapy to breast or chest wall was as safe and effective as a three-week schedule (40 Gy/15Fr) for early breast cancer. The nodal sub-study investigated whether a... Read More about Patient- and clinician-assessed five-year normal tissue effects following one-week versus three-week axillary radiotherapy for breast cancer: Results from the phase III FAST-Forward trial randomised nodal sub-study..

Differential benefit of adjuvant everolimus according to endocrine therapy backbone in the randomized UNIRAD trial. (2025)
Journal Article
Saint-Ghislain, M., Chabaud, S., Dalenc, F., Allouache, D., Cameron, D., Martinez, M., Grenier, J., Barthelemy, P., Brunt, M., Kaluzinski, L., Mailliez, A., Legouffe, E., Hardy-Bessard, A.-C., Giacchetti, S., Mouret-Reynier, M.-A., Canon, J.-L., Bliss, J., Lemonnier, J., Andre, F., Bachelot, T., & Cottu, P. (2025). Differential benefit of adjuvant everolimus according to endocrine therapy backbone in the randomized UNIRAD trial. ESMO Open, 10(5), Article 105050. https://doi.org/10.1016/j.esmoop.2025.105050

The randomized, double-blind UNIRAD trial evaluating the addition of 2 years of everolimus to endocrine therapy in patients with high-risk, early luminal breast cancer failed to demonstrate a benefit. We report the subgroup analyses. We randomly assi... Read More about Differential benefit of adjuvant everolimus according to endocrine therapy backbone in the randomized UNIRAD trial..

Regional Lymph Node Delineation variability and its Dosimetric Impact in Breast Cancer Radiotherapy. (2025)
Journal Article
Nabi, Z., Megias, D., Diez, P., Caraman, A., Mir, R., Wheatley, D., Maclennan, M., Bliss, J., Haviland, J., Sydenham, M. A., Spezi, E., Tsang, Y., & Brunt, A. M. (2025). Regional Lymph Node Delineation variability and its Dosimetric Impact in Breast Cancer Radiotherapy. Clinical Oncology, 42(June 2025), Article 103836. https://doi.org/10.1016/j.clon.2025.103836

To quantify the interobserver variability of regional lymph node delineation for breast cancer radiotherapy (RT) and establish whether a relationship exists between contouring variations and dosimetry using the FAST-Forward (FF) pre-trial RT quality... Read More about Regional Lymph Node Delineation variability and its Dosimetric Impact in Breast Cancer Radiotherapy..

Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial. (2023)
Journal Article
Velikova, G., Morden, J. P., Haviland, J. S., Emery, C., Barrett-Lee, P., Earl, H., Bloomfield, D., Brunt, A. M., Canney, P., Coleman, R., Verrill, M., Wardley, A., Bertelli, G., Ellis, P., Stein, R., Bliss, J. M., & Cameron, D. (in press). Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial. Lancet Oncology, S1470-2045(23)00460-6. https://doi.org/10.1016/S1470-2045%2823%2900460-6

Adjuvant chemotherapy for patients with early breast cancer improves outcomes but its toxicity affects patients' quality of life (QOL). The UK TACT2 trial investigated whether accelerated epirubicin improves time to recurrence and if oral capecitabin... Read More about Accelerated versus standard epirubicin followed by cyclophosphamide, methotrexate, and fluorouracil or capecitabine as adjuvant therapy for breast cancer (UK TACT2; CRUK/05/19): quality of life results from a multicentre, phase 3, open-label, randomised, controlled trial..

Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): a multicentre, phase 3, non-inferiority, open-label, randomised controlled trial. (2023)
Journal Article
Coles, C. E., Haviland, J. S., Kirby, A. M., Griffin, C. L., Sydenham, M. A., Titley, J. C., Bhattacharya, I., Brunt, A. M., Chan, H. Y. C., Donovan, E. M., Eaton, D. J., Emson, M., Hopwood, P., Jefford, M. L., Lightowlers, S. V., Sawyer, E. J., Syndikus, I., Tsang, Y. M., Twyman, N. I., Yarnold, J. R., & Bliss, J. M. (in press). Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): a multicentre, phase 3, non-inferiority, open-label, randomised controlled trial. Lancet, 401(10394), 2124-2137. https://doi.org/10.1016/S0140-6736%2823%2900619-0

A tumour-bed boost delivered after whole-breast radiotherapy increases local cancer-control rates but requires more patient visits and can increase breast hardness. IMPORT HIGH tested simultaneous integrated boost against sequential boost with the ai... Read More about Dose-escalated simultaneous integrated boost radiotherapy in early breast cancer (IMPORT HIGH): a multicentre, phase 3, non-inferiority, open-label, randomised controlled trial..

Hypofractionation: The standard for external beam breast irradiation (2023)
Journal Article
Brunt, A. M., & Haviland, J. S. (2023). Hypofractionation: The standard for external beam breast irradiation. Breast, 69, 410-416. https://doi.org/10.1016/j.breast.2023.04.006

This overview provides the historical perspective of external beam breast hypofractionation over the last 50 years. It highlights the serious harm suffered by patients with breast cancer in the 1970's and 1980's because of new hypofractionation regim... Read More about Hypofractionation: The standard for external beam breast irradiation.

Hypofractionation: The standard for external beam breast irradiation (2023)
Journal Article
Brunt, A. M., & Haviland, J. S. (2023). Hypofractionation: The standard for external beam breast irradiation. Breast, 69, 410 - 416. https://doi.org/10.1016/j.breast.2023.04.006

This overview provides the historical perspective of external beam breast hypofractionation over the last 50 years. It highlights the serious harm suffered by patients with breast cancer in the 1970's and 1980's because of new hypofractionation regim... Read More about Hypofractionation: The standard for external beam breast irradiation.

Detailed Sub-study Analysis of the SECRAB Trial: Quality of Life, Cosmesis and Chemotherapy Dose Intensity (2023)
Journal Article
Fernando, I., Lax, S., Bowden, S., Ahmed, I., Steven, J., Churn, M., Brunt, A., Agrawal, R., Canney, P., Stevens, A., & Rea, D. (2023). Detailed Sub-study Analysis of the SECRAB Trial: Quality of Life, Cosmesis and Chemotherapy Dose Intensity. Clinical Oncology, 35(6), 397-407. https://doi.org/10.1016/j.clon.2023.03.007

Aims
SECRAB was a prospective, open-label, multicentre, randomised phase III trial comparing synchronous to sequential chemoradiotherapy (CRT). Conducted in 48 UK centres, it recruited 2297 patients (1150 synchronous and 1146 sequential) between 2 J... Read More about Detailed Sub-study Analysis of the SECRAB Trial: Quality of Life, Cosmesis and Chemotherapy Dose Intensity.

Aromatase inhibition plus/minus Src inhibitor saracatinib (AZD0530) in advanced breast cancer therapy (ARISTACAT): a randomised phase II study. (2023)
Journal Article
Oswald, A., Symeonides, S., Wheatley, D., Chan, S., Brunt, A., McAdam, K., Schmid, P., Waters, S., Poole, C., Twelves, C., Perren, T., Bartlett, J., Piper, T., Chisholm, E., Welsh, M., Hill, R., Hopcroft, L., Barrett-Lee, P., & Cameron, D. (2023). Aromatase inhibition plus/minus Src inhibitor saracatinib (AZD0530) in advanced breast cancer therapy (ARISTACAT): a randomised phase II study. Breast Cancer Research and Treatment, 199, https://doi.org/10.1007/s10549-023-06873-8

PURPOSE: The development of oestrogen resistance is a major challenge in managing hormone-sensitive metastatic breast cancer. Saracatinib (AZD0530), an oral Src kinase inhibitor, prevents oestrogen resistance in animal models and reduces osteoclast a... Read More about Aromatase inhibition plus/minus Src inhibitor saracatinib (AZD0530) in advanced breast cancer therapy (ARISTACAT): a randomised phase II study..

Cost-effectiveness of 5 fraction and partial breast radiotherapy for early breast cancer in the UK: model-based multi-trial analysis. (2022)
Journal Article
Glynn, D., Bliss, J., Brunt, A. M., Coles, C. E., Wheatley, D., Haviland, J. S., Kirby, A. M., Longo, F., Faria, R., Yarnold, J. R., & Griffin, S. (2022). Cost-effectiveness of 5 fraction and partial breast radiotherapy for early breast cancer in the UK: model-based multi-trial analysis. Breast Cancer Research and Treatment, 197, 405-416. https://doi.org/10.1007/s10549-022-06802-1

PURPOSE: We estimated the cost-effectiveness of 4 radiotherapy modalities to treat early breast cancer in the UK. In a subgroup of patients eligible for all modalities, we compared whole-breast (WB) and partial breast (PB) radiotherapy delivered in e... Read More about Cost-effectiveness of 5 fraction and partial breast radiotherapy for early breast cancer in the UK: model-based multi-trial analysis..

Combined Perioperative Lapatinib and Trastuzumab in Early HER2-Positive Breast Cancer Identifies Early Responders: Randomized UK EPHOS-B Trial Long-Term Results (2022)
Journal Article
Bundred, N., Porta, N., Brunt, A. M., Cramer, A., Hanby, A., Shaaban, A. M., Rakha, E. A., Armstrong, A., Cutress, R. I., Dodwell, D., Emson, M. A., Evans, A., Hartup, S. M., Horgan, K., Miller, S. E., McIntosh, S. A., Morden, J. P., Naik, J., Narayanan, S., Ooi, J., …Bliss, J. M. (2022). Combined Perioperative Lapatinib and Trastuzumab in Early HER2-Positive Breast Cancer Identifies Early Responders: Randomized UK EPHOS-B Trial Long-Term Results. Clinical Cancer Research, 28(7), 1323 - 1334. https://doi.org/10.1158/1078-0432.CCR-21-3177

PURPOSE: EPHOS-B aimed to determine whether perioperative anti-HER2 therapy inhibited proliferation and/or increased apoptosis in HER2-positive breast cancer. PATIENTS AND METHODS: This randomized phase II, two-part, multicenter trial included newly... Read More about Combined Perioperative Lapatinib and Trastuzumab in Early HER2-Positive Breast Cancer Identifies Early Responders: Randomized UK EPHOS-B Trial Long-Term Results.

The challenge of equipoise: qualitative interviews exploring the views of health professionals and women with multiple ipsilateral breast cancer on recruitment to a surgical randomised controlled feasibility trial (2022)
Journal Article
Ingram, J., Beasant, L., Benson, J., Brunt, A. M., Maxwell, A., Harvey, J. R., Greenwood, R., Roberts, N., Williams, N., Johnson, D., & Winters, Z. (2022). The challenge of equipoise: qualitative interviews exploring the views of health professionals and women with multiple ipsilateral breast cancer on recruitment to a surgical randomised controlled feasibility trial. Pilot and Feasibility Studies, 8(1), Article ARTN 46. https://doi.org/10.1186/s40814-022-01007-1

Background
A multicentre feasibility trial (MIAMI), comparing outcomes and quality of life of women with multiple ipsilateral breast cancer randomised to therapeutic mammoplasty or mastectomy, was conducted from September 2018 to March 2020. The MIA... Read More about The challenge of equipoise: qualitative interviews exploring the views of health professionals and women with multiple ipsilateral breast cancer on recruitment to a surgical randomised controlled feasibility trial.

European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer. (2021)
Journal Article
Meattini, I., Becherini, C., Boersma, L., Kaidar-Person, O., Nader Marta, G., Montero, A., Vrou Offersen, B., Aznar, M. C., Belka, C., Brunt, A. M., Dicuonzo, S., Franco, P., Krause, M., MacKenzie, M., Marinko, T., Marrazzo, L., Ratosa, I., Scholten, A., Senkus, E., Stobart, H., …Coles, C. E. (2022). European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer. Lancet Oncology, 23(1), e21 - e31. https://doi.org/10.1016/S1470-2045%2821%2900539-8

High-quality randomised clinical trials testing moderately fractionated breast radiotherapy have clearly shown that local control and survival is at least as effective as with 2 Gy daily fractions with similar or reduced normal tissue toxicity. Fewer... Read More about European Society for Radiotherapy and Oncology Advisory Committee in Radiation Oncology Practice consensus recommendations on patient selection and dose and fractionation for external beam radiotherapy in early breast cancer..

Five-fraction Radiotherapy for Breast Cancer: FAST-Forward to Implementation (2021)
Journal Article
Brunt, A. M., Haviland, J. S., Kirby, A. M., Somaiah, N., Wheatley, D. A., Bliss, J. M., & Yarnold, J. R. (2021). Five-fraction Radiotherapy for Breast Cancer: FAST-Forward to Implementation. Clinical Oncology, 33(7), 430-439. https://doi.org/10.1016/j.clon.2021.04.016

INTRODUCTION: The phase 3 FAST-Forward trial reported outcomes for 26 and 27 Gy schedules delivered in 5 fractions over 1 week versus 40 Gy in 15 fractions over 3 weeks in 4000 patients. We discuss concerns raised by the radiotherapy community in rel... Read More about Five-fraction Radiotherapy for Breast Cancer: FAST-Forward to Implementation.

When the World Throws You a Curve Ball: Lessons Learned in Breast Cancer Management (2021)
Journal Article
Obeng-Gyasi, S., Coles, C. E., Jones, J., Sacks, R., Lightowlers, S., Bliss, J. M., Brunt, A. M., Haviland, J. S., Kirby, A. M., & Kalinsky, K. (2021). When the World Throws You a Curve Ball: Lessons Learned in Breast Cancer Management. American Society of Clinical Oncology educational book, 41(41), e79-e89. https://doi.org/10.1200/edbk_320691

In the care of patients with operable breast cancer, there has been a shift toward increasing use of neoadjuvant therapy. There are benefits to neoadjuvant therapy, such as monitoring for response, as well as an increased rate of breast conservation... Read More about When the World Throws You a Curve Ball: Lessons Learned in Breast Cancer Management.

4 Gy versus 24 Gy radiotherapy for follicular and marginal zone lymphoma (FoRT): long-term follow-up of a multicentre, randomised, phase 3, non-inferiority trial (2021)
Journal Article
Hoskin, P., Popova, B., Schofield, O., Brammer, C., Robinson, M., Brunt, A. M., Madhavan, K., Illidge, T., Gallop-Evans, E., Syndikus, I., Clifton-Hadley, L., & Kirkwood, A. A. (2021). 4 Gy versus 24 Gy radiotherapy for follicular and marginal zone lymphoma (FoRT): long-term follow-up of a multicentre, randomised, phase 3, non-inferiority trial. Lancet Oncology, 22(3), 332-340. https://doi.org/10.1016/S1470-2045%2820%2930686-0

BACKGROUND: The optimal radiotherapy dose for indolent non-Hodgkin lymphoma is uncertain. We aimed to compare 24 Gy in 12 fractions (representing the standard of care) with 4 Gy in two fractions (low-dose radiation). METHODS: FoRT (Follicular Radioth... Read More about 4 Gy versus 24 Gy radiotherapy for follicular and marginal zone lymphoma (FoRT): long-term follow-up of a multicentre, randomised, phase 3, non-inferiority trial.