CAR T cell foundation model predicts immunotherapy response

Single-cell transcriptomics resolves CAR T-cell states, yet translating heterogeneous cellular signals into patient-level therapeutic response remains challenging. Existing studies primarily identify response-associated genes or cell populations through experimental and statistical analyses, but few predictive frameworks integrate gene-level structure with clinical outcomes. Here, we present gANCHOR, a T-cell foundation model built on a hierarchical hypergraph attention framework combining biologically informed representation learning with patient-level response prediction. By encoding gene-pathway relationships, gANCHOR learns pathway-aware cell embeddings that improve biological conservation and batch robustness. A cell-to-patient attention module then aggregates cellular information to infer therapeutic response. Across benchmark datasets, gANCHOR achieved the strongest overall performance in biological conservation and batch-correction assessments. In response prediction across 161 patients from five CAR T-cell studies, gANCHOR achieved an F1 score of 0.87, outperforming benchmarked single-cell foundation models. gANCHOR also identified reproducible response- and non-response-associated gene programs, providing interpretable biological insights into CAR T-cell efficacy and resistance.