In a proof-of-concept study, Lindner et al. have shown that a mathematical model called DR_MOMP has potential as a prognostic tool for stage III colorectal cancer (CRC). The BCL-2 protein family are regulators of apoptosis via mitochondrial outer membrane permeabilization (MOMP) — a key process in chemotherapy-induced cell death. The researchers established DR_MOMP to model the highly complex regulation of MOMP by BCL-2 proteins but have now applied this model to CRC prognosis in patients. BCL-2 protein levels were determined from 128 CRC tumours collected from patients with stage III CRC before DR_MOMP was applied to stratify patients as high or low risk. High-risk patients had a fivefold increased risk of death than low-risk patients, and the DR_MOMP signature was found to be superior to established histopathological risk factors. The DR_MOMP prognostic signature was also validated in 156 patients from The Cancer Genome Atlas project.