Beyond Expansion: Tumor Debulking as Key to Improving CAR T-Cell Potential in Lymphoma.

In this issue of Blood Cancer Discovery, Pomeroy and colleagues explore a population pharmacokinetic/pharmacodynamic model of axicabtagene ciloleucel in large B-cell lymphoma, quantifying how tumor debulking before chimeric antigen receptor (CAR) T-cell infusion can significantly improve durable remission rates. Their framework incorporates mechanistic modeling principles of CAR T-cell biology and therapy, such as CAR T-cell expansion, binding, killing, and stochastic CD19 loss, providing actionable insights for optimizing combination approaches and future trial design. See related article by Pomeroy et al., p. 41.