Randomised phase 3 trials remain the most important method for comparing treatment regimens and setting new standards of care. The GAIA/CLL13 study is a phase 3 trial that answers several important questions about how to treat patients with chronic lymphocytic leukaemia.1,2 In The Lancet Oncology, Moritz Fürstenau and colleagues now report updated 4-year follow up data in an exploratory analysis.1 In the study, treatment-naive, fit patients with chronic lymphocytic leukaemia were randomly assigned to one of four treatment groups.