Table 2.

Core longitudinal procedures and implementation criteria of the developed supportive care pathway

Procedure	Purpose within the pathway	Key operational elements and implementation criteria
Assessment and planning	Identify baseline risks and establish an individualised supportive care plan	MDT-led baseline assessment at T0, including sarcopenia status, nutritional status, symptoms, functional capacity, and psychosocial risks. Findings are used to stratify risk and develop an individualised care plan
One-to-one education	Enhance patient understanding, engagement, and self-management capacity	Nurse-led education with MDT support begins at pathway entry and is reinforced throughout treatment according to individual needs. Education covers sarcopenia prevention, nutrition, exercise, symptom management, and home-based self-management. Family involvement is encouraged and incorporated where appropriate and with the patient’s agreement
Weekly monitoring	Identify early deterioration and enable timely supportive-care adjustment	Nurses conduct weekly monitoring of body weight, oral intake, nutritional status, functional changes, symptoms, exercise adherence, treatment tolerance, and patient concerns. Findings are reviewed against predefined escalation criteria, including ≥ 2.5% body weight loss from T0 baseline, inadequate nutritional intake, worsening symptoms, functional decline, or poor adherence, with referral to relevant MDT members when required
MDT consultation for complex or escalating needs	Provide coordinated multidisciplinary decision-making when supportive-care needs become complex or clinically significant deterioration occurs	Trigger-based MDT consultation is initiated for clinically meaningful deterioration or complex supportive-care needs, including ≥ 2.5% body weight loss from T0 baseline, emerging sarcopenia risk, persistent or severe symptoms, nutritional or functional decline, exercise intolerance, high fall risk, or other concerns requiring multidisciplinary input. The MDT reviews contributing factors and modifies or intensifies the care plan as appropriate
MDT reassessment at key treatment time points	Evaluate treatment-related changes and adjust supportive-care intensity at key treatment milestones	Scheduled MDT reassessment is conducted at predefined treatment milestones. The MDT reviews changes in nutritional and functional status, symptoms, adherence, treatment tolerance and safety, and adjusts supportive-care strategies according to the patient’s current risk status
End-of-treatment MDT review and care summary	Review pathway delivery, consolidate care outcomes, and identify ongoing supportive-care needs	At completion of definitive treatment, the MDT and nurse coordinator conduct an end-of-treatment review and prepare a concise care summary covering clinical changes, interventions provided, adherence, referrals, safety events, and unresolved supportive care needs. Patients requiring continued support are referred for appropriate follow-up management

MDT multidisciplinary team, T0 baseline; safety-related temporary-suspension, resumption, and permanent-discontinuation criteria are described in the main text. The complete prespecified safety framework is reported in the published pilot randomised controlled trial protocol [54]