Background: A cloud-based bidirectional app (ePRO) communicating real-time patient-reported cancer treatment symptom(s)/severity and clinical care team (CCT) recommendation(s) can lessen treatment burden. Previous studies have focused on a single diagnosis or treatment modality, but not institution-wide, multi-modal use. Methods: Tampere University Hospital oncology patients (Pt; n=1,873) receiving radiotherapy (RT), systemic therapy (chemo-, immune-, or hormone therapy; ST) or both (RT+ST) modalities with active ePRO accounts between 2015-2021 were asked to complete an app-based treatment-specific questionnaire administered regularly. It was also available ad hoc. Items assessed overall distress (11-point scale; 0=none,10=Worst Possible), physical function (ECOG-based), and treatment symptoms (CTCAE-based; v5). Prespecified responses were programmed to alert the CCT, which in turn, provided customized, app-based recommendations. All data were analyzed descriptively. Results: Pts were predominantly female and middle-aged. The two most common cancer types were breast and prostate; each of the others comprised <5% of the sample and were grouped into “other”. Most received RT+ST (concurrent or sequential). Mean time on active treatment ranged from 4.2 to 11.4 months. The response rate ranged from 82.2% to 87.3%. The most common symptoms were fatigue and pain, with almost a quarter of Pts reporting severe pain. Higher severity levels were reported by patients receiving any ST (Table 1). Conclusions: Pt’s high engagement rate with the app demonstrates that a single, actionable solution can be successfully employed across the continuity of care, despite varying regimens and schedules, and is a behavioral indicator of its value.