The Promise and Limits of Remote Patient Monitoring for Bispecific Antibodies

Tara M. Graff, DO, director of clinical research at Mission Cancer + Blood at the University of Iowa Health Care, discussed findings from an abstract at ASH 2025 evaluating the use of remote patient monitoring (RPM) to support outpatient step-up dosing of bispecific antibodies. The analysis explored whether RPM could help a large academic center safely expand outpatient administration and reduce reliance on inpatient hospitalization.

Graff noted that the study, though small, demonstrated potential benefits of RPM, particularly in detecting cytokine release syndrome (CRS) earlier in some patients. Earlier identification of changes in vital signs could allow for more rapid intervention and escalation of care, an important consideration as practices seek alternatives to labor-intensive, around-the-clock human monitoring. For community sites without the infrastructure to support extended after-hours clinics or frequent monitoring calls, RPM may offer a viable pathway to outpatient bispecific delivery.

However, Graff emphasized important limitations that affect generalizability. Patient adherence to wearable devices and the relatively short duration of monitoring—averaging approximately 8 days despite longer step-up dosing periods—raise questions about sustainability and consistency. She also highlighted the limitations of device-based monitoring compared with direct human interaction. While some RPM platforms can track temperature, heart rate, blood pressure, and oxygenation, devices may miss contextual factors, such as antipyretic use, that can mask hallmark CRS symptoms like fever.

In current practice, Graff explained, her dedicated bispecific team conducts frequent phone-based assessments during step-up dosing, allowing for nuanced clinical judgment that no existing device can fully replicate. Nonetheless, she acknowledged that such staffing models may not be scalable nationwide as bispecific use expands. RPM technologies may ultimately help bridge this gap, particularly as volumes increase and community practices seek practical solutions.

Overall, the data suggest that RPM holds promise as a supportive tool for outpatient bispecific administration, but further validation in larger populations is needed. Hybrid approaches that combine technology with human oversight—and potentially more advanced analytics in the future—will likely be required before RPM can reliably replace traditional monitoring models.