I have 5950x and 3090FE and I made one simple change that allows me to crank up pretty much every setting to max with 30fps+:
Turn off SMT in your bios for your CPU. It effectively turns your 16C 32T into 16C 16T. I have PBO enabled with negative 15 in curve optimiser also.
I’m running openxr at 70%, reprojection off with 120TAA, ultra everything. G-sync off.
I’m going to try cranking up the custom render scale and may turn down some effects to see if I can push it more but honestly it looks amazing now.
2D mode is pure butter now too at 60fps.
Let me know if this works for you.