Tele-nutritional collaborative care in patients with stage IV gastrointestinal cancer receiving chemotherapy: A randomized clinical trial.

12043 Background: Cancer cachexia is characterized by systemic inflammation and progressive muscle loss, fundamentally compromising quality of life (QOL) and overall survival. While early nutritional intervention is imperative, patients in resource-constrained regions like Western China often lack timely access. We conducted the tele-nutrition collaborative care (T-NICE) trail to evaluate the efficacy of a hybrid remote care delivery model for patients with stage IV gastrointestinal cancer undergoing chemotherapy. Methods: This randomized clinical trial was conducted at West China Hospital. Patients with histologically confirmed stage IV gastrointestinal cancer (esophageal, gastric, or colorectal) were randomly assigned (1:1) to the T-NICE intervention versus Standard Nutrition Care (SNC). The T-NICE group received a collaborative hybrid telecare model involving a lean team (dietitian and social worker), comprising an initial in person education followed by app-based monitoring and adaptive telephone counseling. Primary Endpoint: The incidence of cancer cachexia (defined as involuntary weight loss >5%, or >2% if BMI