Frank MJ, Hossain NM, Bukhari A, et al. - Researchers investigated prognostic value of circulating tumor DNA (ctDNA) prior to as well as following standard-of-care axicabtagene ciloleucel (axi-cel) for predicting patient outcomes in large B-cell lymphoma cases, in this prospective multicenter study. Of 72 enrolled patients, a tumor clonotype was successfully identified in 69 (96%). Findings revealed that higher pretreatment ctDNA levels were related to progression post- axi-cel infusion and developing cytokine release syndrome and/or immune effector cell–associated neurotoxicity syndrome. Patients with detectable ctDNA vs those with undetectable ctDNA, at day 28, were found to have a median progression-free survival and OS of 3 months vs not reached and 19 months vs not reached, respectively. Findings indicate that risk stratification as well as outcome prediction can be accomplished through noninvasive ctDNA assessments in patients receiving axi-cel for the treatment of large B-cell lymphoma. These findings offer a rationale for designing ctDNA-based risk-adaptive chimeric antigen receptor T-cell clinical trials.