Abstract P2-05-15: Challenges and Communication Gaps in Adjuvant Endocrine Therapy for HR+ Breast Cancer Patients in Russia: Insights from an online Survey

Abstract Background: Adjuvant endocrine therapy is crucial in managing hormone receptor-positive breast cancer, significantly reducing recurrence and improving survival. Despite its benefits, adherence to endocrine therapy is often challenged by side effects, including psychological and sexual dysfunction. These issues are rarely discussed during doctor visits in Russia. Understanding patient perspectives on these issues and their communication with healthcare providers is vital for enhancing adherence and patient support. Materials and Methods: An anonymous online survey was conducted using Google Forms to investigate adherence to adjuvant endocrine therapy, patient-reported side effects, and communication with healthcare providers among breast cancer patients. The survey, distributed via patient advocate groups and online forums, received 920 responses. The survey included questions on adherence, side effects, comfort in discussing side effects with healthcare providers, and whether necessary counseling was received. Data were analyzed to identify key trends and raise questions for further investigation. Results: Participants: 920 women with breast cancer participated in the survey.HR+ Breast Cancer: 919 (99%) had HR+ breast cancer and were prescribed endocrine therapy.Therapy Context: 777 (84.5%) received adjuvant endocrine therapy, and 143 (15.5%) for metastatic breast cancer.Non-Starters: 40 (4.25%) did not start endocrine therapy. Reasons for not starting:Concerned with side effects: 35%Unfavorable harm/benefit ratio: 27.5%Concern about potential secondary tumors: 30%Discomfort with taking pills: 2.5%Concerned with the cost: 5%Median Age: 48 years, with participants from various parts of Russia.Disease Stage:In situ: 1.8%Stage I: 21.6%Stage II: 45.3%Stage III: 23.2%Stage IV: 8%Type of Endocrine Therapy: Anastrozole/Letrozole: 46.8%Tamoxifen: 51.7%Exemestane: 1.5%Medical ovarian suppression: 29.7%Duration of Treatment: < 5 years: 87.6%5 years: 5%5 years: 5.8%10 years: 1%Not sure: 0.7%Adherence: As prescribed: 94.3%Dose interruptions (with physician discussion): 2.7%Dose interruptions (without physician discussion): 0.7%Adverse Effects: Reported by 91.2% of participants. Cardiovascular symptoms: 20.5%Cognitive/mood symptoms: 58.6%Ocular symptoms: 42.4%General physical changes: 58.3%Gastrointestinal symptoms: 25.7%Genitourinary symptoms: 32.4%Bone and joint issues: 67.2%Sexual issues: 47.6%Vasomotor symptoms: 66.2%Financial toxicity: 10%Discussion with Physicians: Never discussed adverse events: 23.9%Attempted discussion: 31.3%Discussed: 44.8%Comfortable discussing issues: 35.1%Felt physician underscored side effects: 40.4%Felt doctor was rushed: 21.3%Management Suggestions: No suggestion: 65.8%Lifestyle modification (diet and exercise): 35.8%Referral to other physicians: 23.6%Prescribed medications: 16.4%Offered to switch endocrine drug: 4.7%Therapy Discontinuation: 23% reported stopping endocrine therapy earlier than planned with the healthcare team. Conclusions: The survey reveals significant challenges in adherence to adjuvant endocrine therapy among breast cancer patients in Russia, primarily due to side effects and insufficient communication with healthcare providers. A substantial number of patients do not discuss adverse effects with their physicians, and many feel their concerns are not adequately addressed. Improved patient-physician communication and better management strategies for side effects are essential to enhance adherence and support for patients undergoing endocrine therapy. Further studies are needed to develop interventions that can mitigate these issues and improve patient outcomes. Citation Format: Anastasia Danilova, Daniil Stroykovsky, Irina Nigmatullina, Angelina Osheichik, Laura Malishava. Challenges and Communication Gaps in Adjuvant Endocrine Therapy for HR+ Breast Cancer Patients in Russia: Insights from an online Survey [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-05-15.