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iwCLL 2025 | MAVRiC trial: mutation-guided time-limited AV after frontline cBTKi + ven in patients with CLL/SLL
In this video, Matthew Davids, MD, Dana-Farber Cancer Institute, Boston, MA, introduces the MAVRiC trial (NCT07024706). This Phase II study will assess the safety and efficacy of a retreatment strategy using acalabrutinib and venetoclax (AV) in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) who have relapsed following a treatment regimen of venetoclax plus a covalent BTK inhibitor (cBTKi) (± obinutuzumab) in the first-line setting. Dr Davids highlights that a unique aspect of the trial is the mutation-guided approach, with patients receiving shorter or longer therapy based on their IGHV status. This interview took place at the biennial International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2025 in Krakow, Poland.
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Transcript
So the MAVRiC trial is looking at a retreatment strategy with acalabrutinib and venetoclax, or AV, in patients with CLL who previously had BTK and BCL2-based therapy in the frontline setting. It’s pretty open eligibility in terms of patients could have had a doublet or triplet-based therapy. They could have had ibrutinib or acalabrutinib-based therapy. And when they relapse, they move into this study and can then be treated with acalabrutinib and venetoclax...
So the MAVRiC trial is looking at a retreatment strategy with acalabrutinib and venetoclax, or AV, in patients with CLL who previously had BTK and BCL2-based therapy in the frontline setting. It’s pretty open eligibility in terms of patients could have had a doublet or triplet-based therapy. They could have had ibrutinib or acalabrutinib-based therapy. And when they relapse, they move into this study and can then be treated with acalabrutinib and venetoclax. And one of the unique aspects of the MAVRiC study is that, rather than using a fixed-duration or an MRD-guided strategy, it actually uses a mutationally guided strategy. And what I mean by that is that the duration of therapy is based on the IGHV mutational status of the patients. So patients who have mutated IGHV are typically more sensitive to these treatments and receive a shorter course of one year. Whereas we know that patients with unmutated IGHV tend to have a more aggressive form of CLL, and so they receive two years of therapy. And the hope is that both groups of patients will be able to achieve durable remissions with this different length of therapy. And this study is just going to be getting underway hopefully this fall. And we have this poster here to present the design of the study.
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Disclosures
Consulting: AbbVie, Adaptive Biotechnologies, Ascentage Pharma, AstraZeneca, BeiGene, Bristol-Myers Squibb, Eli Lilly, Galapagos, Genentech, Genmab, Janssen, Merck, MEI Pharma, Nuvalent, Schrödinger; Research Support: Ascentage, AstraZeneca, MEI Pharma, Novartis.
