Majic trial arm "A"

[JDG45]

For the Majic trail, arm "A", I would like to know if anyone has completed the first 15 cycles of Acalabrutinib and Venetoclax. Has your bone marrow testing showed below MRD indicating deep remission. My test comes up in June with my fingers crossed.

[Horatio2]

Hi JDG45. I finished my 15-cycles on the MAJIC trial—A + V arm of the trial — in January. While my BMB showed uMRD, my peripheral blood did not. Therefore, I am continuing on the medication as the trial dictates. I will be finished in October when I will be tested again. Good luck on your tests!

[Poodle2 in reply to Horatio2]

I always thought if you are uMRD in BMB, you have to be in peripheral blood. Strange...glad you can continue with the medication. All the best.

[Horatio2 in reply to Poodle2]

I’m not sure, but goodness knows that if there’s going to be an exception to a rule, it will be me! Maybe someone else can chime in and let me know if I’m doomed.

[Poodle2 in reply to Horatio2]

I didn't mean to alarm you! Sorry if I did. That's definitely not what I meant. I was just surprised that if you weren't uMRD in blood, I wouldn't expect you to be in BMB. Being uMRD in BMB is definitely a good thing 🙂and you can continue taking the drugs which is fantastic too. They will make sure you reach uMRD everywhere 🙂

[Horatio2 in reply to Poodle2]

LOL. You didn’t alarm me. I was just trying to make a joke. I don’t think I’m doomed yet, and we are both going to get through this trial in much better shape than when we started!! Keep me updated!

[Poodle2 in reply to Horatio2]

Oh good 😁

[Sojomama13 in reply to Poodle2]

Hi,

I have been UMRD in blood for years, although still traceable in my bone marrow.

Sandy

[Vlaminck in reply to Sojomama13]

Interesting!

[Amy4steve3 in reply to Horatio2]

I’m on arm A as well, I am mutated 13q w bulky disease, at my year point, BMB indicated that I had still a few to many cancer cells, and a couple lymph nodes being stubborn in my Ct scan, so 1 more year for me as well, blood work looks pretty normal except for platelets being slightly low at 90 . But I feel good!

[JDG45 in reply to Amy4steve3]

Did you also have MRD tested in you peripheral at the same time? I thought the golden rule was there were always more B cells in the BM but from some replies to my questons that is not the case.

[Skyshark]

If the GLOW, CAPTIVATE and FLAIR trials of V+I are anything to go by it takes longer to reach uMRD4 on BCL2+BTKi than on BCL2+MAb. But the duration of remission on 15 cycle CAPTIVATE FD is very similar to 12 cycle CLL14 for V+O. This might indicate that uMRD4 is less of a prognostic of remission for BCL2+BTKi than for BCL2+MAb.

A finding of GLOW was uMRD is not important for m-CLL remission.

The takeaway from FLAIR is uMRD takes longer to reach for m-CLL and extending time on treatment in trying to attain uMRD4 has little effect on progression free survival for m-CLL compared to shorter duration treatments.

FLAIR shows extending time on treatment had a major effect for u-CLL. CAPITVATE MRD has also shown good results for both those that attained uMRD4 and those that didn't but then went on to continuous Ibrutinib. MAJIC is looking for a halfway house with a limited extension time.

[Vlaminck in reply to Skyshark]

Thanks for info. For those new here, I'm assuming McLL means mutated and UCLL means unmutated.