What is the compaction type ?
What is the size of each partition, make sure partitions size is 100 MB max, Large partitions will cause GC pauses
What is the consistency level ?
Make sure you have no disk issues, high disk queue size
https://support.datastax.com/s/article/HOW-TO-Use-iostat-to-diagnose-CPU-and-IO-bottlenecks
Also check if there are too many memtable flushes, values of these parameters
memtable_heap_space_in_mb, memtable_cleanup_threshold
Do you see frequent tombstones in logs ?