Teams from Roswell Park and New York City discuss advances in CAR T-cell therapy for large B-cell lymphoma. Team Roswell presents real-world data comparing second-line CAR T therapy with standard salvage chemotherapy and transplant approaches, highlighting improved event-free and overall survival outcomes with CAR T. Team NYC challenges the findings, raising questions about patient selection, treatment bias, and how real-world data should be interpreted alongside randomized clinical trial results.