Gutierrez A, et al. - In view of the observation that 30%-40% of patients with DLBCL fail with standard treatment, researchers sought to determine the utility of Tumor Score (TS)—a score reported by the MD Anderson Cancer Center in the prerituximab era exclusively considering tumor-related variables—in recognizing patients that are candidates for alternative therapies in the rituximab era. They appraised the Tumor Score (TS), revised in the rituximab era (R-TS) and provided an evolution of the score (Enhanced-TS). Patients homogeneously treated with R-CHOP (n = 1,327) were selected from GELTAMO DLBCL registry. Outcomes revealed 5y-PFS and OS of 62% and 74%. In the R-TS, all variables retained an independent prognostic role in the rituximab era, distinguishing four different risk groups, with 5y-PFS of 86%, 71%, 50% and very high risk (HR) (28%). When compared with previously reported prognostic scores, TS remained predictive of PFS and OS in the rituximab era with similar discrimination. Relative to the International Prognostic Index (IPI) or NCCN-IPI, TS and enhanced-TS resulted in better identification of patients with HR prognosis. Based on findings they suggest that for incorporating new tumor-related molecular or translational prognostic factors, R-TS and enhanced-TS may be backbones.