Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, discusses how best to deal with Richter’s transformation. Dr Eichhorst begins by stating that the best treatment for Richter’s transformation is to control the chronic lymphocytic leukemia (CLL), so that the transformation will not have a chance to develop. Dr. Eichhorst mentions a presentation given at this year’s GCLLSG congress, showing the different mutations observed in Richter’s transformation in comparison to de novo diffuse large B-cell lymphoma (DLBCL). It is already established that Richter’s is a completely different disease to DLBCL and CLL. As there are so many genetic aberrations in Richter’s transformation, patients could respond well to checkpoint inhibitors. It is known from lung cancer, that patients who have tumors with a high mutation load, respond better to checkpoint inhibitors than others do. Furthermore, there is also some first data that checkpoint inhibitors might be a treatment option for Richter’s transformation and more data is expected in the next couple of years as well as hopefully better treatment options. Recorded at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany.