Postbiotics Ameliorate Cachexia in Patients With Non-small-cell Lung Cancer

Inclusion Criteria: 1. Age ≥ 18 years, regardless of gender. \- 2. Patients with histologically or cytologically confirmed non-small-cell lung cancer (NSCLC) classified as stage III-IV according to the 9th TNM edition of IASLC, who are either currently receiving or have completed chemotherapy combined with immunotherapy. \- 3. Cachexia was diagnosed according to the international consensus criteria: involuntary weight loss \>5 % within 6 months preceding screening, or BMI \<20 kg/m² combined with \>2 % involuntary weight loss within the same period. \- 4. Eastern Cooperative Oncology Group (ECOG) performance status ≤ 3 and an estimated life expectancy of ≥ 4 months. \- 5. Prior to the first dose of study treatment, adequate organ function must be documented (no blood products, granulocyte-colony-stimulating factors, or thrombopoietic agents within 14 days before randomisation): 1) Absolute neutrophil count ≥ 1.5 × 10\^9/L;2)Platelet count ≥ 100 × 10\^9/L; 3) Haemoglobin \> 90 g/L; 4) Serum creatinine \< 1.5 × upper limit of normal (ULN) or creatinine clearance (Cockcroft-Gault) \> 50 mL/min; 5) Total bilirubin \< 1.5 × ULN (\< 3 × ULN in Gilbert's syndrome) ;6) AST and ALT \< 2.5 × ULN (≤ 5 × ULN if hepatic metastases present); 7) INR and aPTT ≤ 1.5 × ULN unless the participant is on therapeutic anticoagulation; 8) Left-ventricular ejection fraction (LVEF) \> 50 % \- 6. Participants must be capable of providing written informed consent and comprehending the potential risks associated with the intervention. \- 7. Participants must demonstrate high adherence to the study protocol. \- 8. Gastrointestinal function score of \< 5. Exclusion Criteria: 1. Current presence of reversible causes of reduced food intake (e.g., oral mucositis or mechanical obstruction). \- 2. Participants who are receiving tube feeding or parenteral nutrition at the time of screening or randomization. \- 3. Cachexia attributable to other etiologies (e.g., chronic obstructive pulmonary disease, heart failure, or HIV/AIDS). \- 4. Major surgery within 4 weeks prior to randomization or major surgery planned during the study period. \- 5. Initiation of systemic corticosteroid therapy within 4 weeks prior to randomization. \- 6. Use of any appetite- or weight-enhancing agent within 30 days before randomisation, including anamorelin, megestrol acetate, cannabinoids, olanzapine, or mirtazapine. \- 7. Use of antibiotics or probiotic-containing medications/foods within 2 weeks prior to randomization. \- 8. Use of glucagon-like peptide-1 (GLP-1) receptor agonists for weight reduction within 30 days prior to randomization. \- 9. Pregnant or lactating women. \- 10. Participants who are unable to understand the study objectives or who do not agree to comply with the study requirements. \- 11. Individuals who lack full legal capacity or whose legal capacity is restricted. \- 12. Any medical condition that could interfere with the interpretation of study results or increase the participant's risk in the opinion of the investigators. \- 13. Participation in any other clinical trial. \- 14. Gastrointestinal function score of ≥ 5.