Home-Based, Connected Care: Dinutuximab Beta Immunotherapy in Neuroblastoma Beyond Feasibility. Improving Quality of Life and Family Satisfaction

Background Anti-GD2 immunotherapy with dinutuximab beta improves survival in patients with high-risk neuroblastoma but usually requires prolonged inpatient administration, with a negative impact on quality of life and family well-being. This study aimed to evaluate the feasibility and safety of a structured home-based administration supported by telemonitoring, and its impact on psychological distress, quality of life, and caregiver perception of care.Procedure Between May 2025 and March 2026, all consecutive pediatric and young adult patients (2-20 years) eligible for home-based dinutuximab beta administration were prospectively included. Treatment followed a stepwise protocol with an initial inpatient phase and subsequent continuation at home supported by remote telemonitoring. Psychological distress was assessed using the Distress Thermometer at three time points, and quality of life using the KIDSCREEN-10 questionnaire. Safety was monitored through remote assessment of vital signs according to Pediatric Early Warning System criteria and adverse event reporting.Results Eleven patients were included. Psychological distress decreased over time in both age groups (2-7 years: median score from 5.5 to 2; 8-20 years: from 6 to 1). Quality-of-life scores improved across multiple domains. Telemonitoring showed stable vital parameters, with no treatment-related severe adverse events. One hospitalization was reported due to a central venous catheter infection unrelated to therapy. Caregiver satisfaction was high, with most families reporting increased perceived safety.Conclusions Home-based dinutuximab beta administration supported by telemonitoring is feasible and safe and is associated with reduced psychological distress and improved quality of life, representing a patient- and family-centered model of care in pediatric oncology.