To the Editor: In the report by Wang et al. (June 30 issue)1 on the randomized, controlled SHINE trial of first-line ibrutinib plus bendamustine and rituximab as compared with placebo plus bendamustine and rituximab in patients with mantle-cell lymphoma, a progression-free survival benefit was shown, with no significant difference in overall survival or patient-reported outcomes. Unfortunately, it is difficult to interpret the relevance of the trial, because only 38.7% of the patients in the control group received an appropriate standard-care treatment on progression, which was then — and remains — a Bruton’s tyrosine kinase (BTK) inhibitor.2-4 This trial-design choice unfairly . . .