At the 2025 American Society of Hematology (ASH) Annual Meeting, UCI Health hematologist-oncologist Elizabeth Brem, MD, shared a candid perspective on a challenge many oncologists face in everyday practice: the discomfort with doing less, even when data suggest it may be appropriate.

Drawing on real-world experience and emerging evidence shared at the meeting, Brem discusses why de-escalation strategies for carefully selected patients with aggressive large cell lymphoma deserve thoughtful consideration, and why historical “more is better” approaches don’t always translate into better outcomes.