The Smart Start trial (NCT02636322) is looking at the combination of rituximab, lenalidomide and ibrutinib alone, prior to combination with chemotherapy, in newly diagnosed diffuse large B-cell lymphoma (DLBCL). Here, Loretta Nastoupil, MD, University of Texas MD Anderson Center, Houston, TX, discusses the results presented by Jason Westin at the 15th International Conference on Malignant Lymphoma (ICML), in Lugano, Switzerland.