Since the introduction of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) as the gold standard for the treatment of diffuse large B-cell lymphoma, clinical investigators have constantly tried to improve its effectiveness by adding new drugs and proposing combinations (ie, R-CHOP plus drug X). 1 This strategy is justified by the great biological heterogeneity of diffuse large B-cell lymphomas, suggesting that R-CHOP cannot be a universal treatment but can instead provide a rational basis for personalised therapy. As such, for the past decade molecular classification on the basis of the distinction between germinal centre B-cell-like and activated B-cell-like subtypes has largely dominated the debate and focused efforts in terms of targeted therapy and biomarker research. 2

To show the potential of such a strategy, biologically relevant, reliable, repro ducible biomarkers and a corresponding effective molecule that are likely to improve the efficacy of the R-CHOP regimen need to be identified. The prospective multicentre phase 3 REMoDL-B trial, reported in The Lancet Oncology by Andrew Davies and colleagues, 3 shows that real-time characterisation of diffuse large B-cell lymphoma is feasible by use of molecular biology with RNA extracted from formalinfixed paraffin-embedded (FFPE) samples and cDNA-mediated annealing, selection, extension, and ligation techniques. 3 Among the 1128 eligible patients in this trial, 918 (81%) were effectively classified according to their cell of origin (244 [27%] activated B cell, 475 [52%] germinal centre B cell, and 199 [22%] unclassified). Phenotyped patients were subsequently randomly assigned (1: 1) after the first R-CHOP cycle to receive either R-CHOP or R-CHOP with bortezomib (RB-CHOP). The primary outcome analysis showed that the addition of bortezomib does not provide any benefit in terms of progressionfree survival in the overall population (30-month