^
10d
Trial completion date • Trial primary completion date • Adverse events • Combination therapy
|
BCL2 (B-cell CLL/lymphoma 2) • CD20 (Membrane Spanning 4-Domains A1) • CCND1 (Cyclin D1) • BCL6 (B-cell CLL/lymphoma 6)
|
Chr t(11;14) • CCND1 overexpression
|
Venclexta (venetoclax) • Imbruvica (ibrutinib) • Rituxan (rituximab) • lenalidomide • doxorubicin hydrochloride • cyclophosphamide • prednisone • Jaypirca (pirtobrutinib) • Epkinly (epcoritamab-bysp) • Polivy (polatuzumab vedotin-piiq) • golcadomide (CC-99282)
19d
Advances in Targeted Therapy: Addressing Resistance to BTK Inhibition in B-Cell Lymphoid Malignancies. (PubMed, Cancers (Basel))
The first-in-class covalent BTK inhibitor, Ibrutinib, binds to the C481 amino acid residue to block the BTK enzyme and prevent the downstream signaling...To bypass the C481S mutation, non-covalent BTKi, such as Pirtobrutinib, were developed and are active against both wild-type and the C481S mutation...In addition, we discuss the new emerging class of BTK degraders, which utilize the evolution of proteolysis-targeting chimeras (PROTACs) to degrade the BTK protein and constitute an important avenue of overcoming resistance. The moving landscape of resistance to BTKi and the development of new therapeutic strategies highlight the ongoing advances being made towards the pursuit of a cure for B-cell lymphoid malignancies.
Review • Journal
|
PLCG2 (Phospholipase C Gamma 2)
|
BTK C481S • BTK C481
|
Imbruvica (ibrutinib) • Brukinsa (zanubrutinib) • Calquence (acalabrutinib) • Jaypirca (pirtobrutinib)
23d
FoxO1/Rictor axis induces a non-genetic adaptation to Ibrutinib via Akt activation in chronic lymphocytic leukemia. (PubMed, J Clin Invest)
Knock-out or inhibition of FoxO1 or Rictor led to a dramatic decrease in Akt phosphorylation and growth disadvantage for malignant B cells in the presence of ibrutinib (or PI3K inhibitor idelalisib) in vitro and in vivo. FoxO1/Rictor/pAktS473 axis represents an early non-genetic adaptation to BCR inhibitor therapy not requiring PI3Kδ or BTK kinase activity. We further demonstrate that FoxO1 can be targeted therapeutically, and its inhibition induces CLL cells' apoptosis alone or in combination with BTK inhibitors (ibrutinib, acalabrutinib, pirtobrutinib) and blocks their proliferation triggered by T-cell factors (CD40L, IL-4, and IL-21).
Journal
|
PIK3CD (Phosphatidylinositol-4 5-Bisphosphate 3-Kinase Catalytic Subunit Delta) • CD40LG (CD40 ligand) • IL21 (Interleukin 21) • IL4 (Interleukin 4)
|
Imbruvica (ibrutinib) • Calquence (acalabrutinib) • Zydelig (idelalisib) • Jaypirca (pirtobrutinib)
28d
OSU-23307: Pirtobrutinib in Combination With Rituximab in Newly Diagnosed Marginal Zone Lymphoma (R+Pirto in Newly Diagnosed MZL) (clinicaltrials.gov)
P2, N=23, Not yet recruiting, University of Utah | Trial completion date: Dec 2025 --> Dec 2032 | Initiation date: May 2024 --> Dec 2024 | Trial primary completion date: Dec 2025 --> Dec 2031
Trial completion date • Trial initiation date • Trial primary completion date • Combination therapy
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib)
1m
Enrollment closed
|
Venclexta (venetoclax) • Jaypirca (pirtobrutinib)
2ms
ERK1/2 pro-survival signalling is suppressed by pirtobrutinib in ibrutinib-resistant MYD88-mutated lymphoma cells. (PubMed, Br J Haematol)
We show that pirtobrutinib blocked p-ERK1/2, ERK1/2-driven inflammatory cytokines, and overcame paracrine-mediated resistance in MYD88Mut lymphoma cells expressing mutated BTKCys481. Our results provide important mechanistic insights for the activity of pirtobrutinib in MYD88Mut lymphomas carrying BTKCys481 mutations.
Journal
|
MYD88 (MYD88 Innate Immune Signal Transduction Adaptor)
|
MYD88 mutation
|
Imbruvica (ibrutinib) • Jaypirca (pirtobrutinib)
2ms
Enrollment change • Trial completion date • Trial primary completion date • Adverse events • Combination therapy
|
BCL2 (B-cell CLL/lymphoma 2) • CD20 (Membrane Spanning 4-Domains A1) • CCND1 (Cyclin D1) • BCL6 (B-cell CLL/lymphoma 6)
|
Chr t(11;14) • CCND1 overexpression
|
Venclexta (venetoclax) • Imbruvica (ibrutinib) • Rituxan (rituximab) • lenalidomide • doxorubicin hydrochloride • cyclophosphamide • prednisone • Jaypirca (pirtobrutinib) • Epkinly (epcoritamab-bysp) • Polivy (polatuzumab vedotin-piiq) • golcadomide (CC-99282)
2ms
Phase 2 Open Label Randomized Study of Pirtobrutinib and Brexucabtagene Autoleucel in R/R MCL (clinicaltrials.gov)
P2, N=60, Recruiting, H. Lee Moffitt Cancer Center and Research Institute | Not yet recruiting --> Recruiting
Enrollment open
|
Jaypirca (pirtobrutinib) • Tecartus (brexucabtagene autoleucel)
2ms
Utilizing risk factors to guide treatment decisions in chronic lymphocytic leukemia. (PubMed, Expert Rev Anticancer Ther)
New treatment modalities, such as pirtobrutinib, lisocabtagene maraleucel, and ongoing studies combining BTK inhibitors with venetoclax, raise new questions on the significance of prognostic factors of survival for patients with CLL. Testing for prognostic biomarkers will remain relevant to identify patients who may have increased benefit from novel therapeutic strategies, such as combination therapies and novel agents. Patients with high-risk disease should be encouraged to participate in clinical trials.
Review • Journal • IO biomarker
|
TP53 (Tumor protein P53) • IGH (Immunoglobulin Heavy Locus)
|
Venclexta (venetoclax) • Breyanzi (lisocabtagene maraleucel) • Jaypirca (pirtobrutinib)
3ms
Phase 2 Open Label Randomized Study of Pirtobrutinib and Brexucabtagene Autoleucel in R/R MCL (clinicaltrials.gov)
P2, N=60, Not yet recruiting, H. Lee Moffitt Cancer Center and Research Institute
New P2 trial
|
Jaypirca (pirtobrutinib) • Tecartus (brexucabtagene autoleucel)
3ms
MIRACLE: Pirtobrutinib and Venetoclax With MRD Detection for Previously Untreated Chronic Lymphocytic Leukemia (clinicaltrials.gov)
P2; Trial completion date: Jul 2025 --> Aug 2027 | Trial primary completion date: Jul 2024 --> Aug 2026
Trial completion date • Trial primary completion date
|
CD20 (Membrane Spanning 4-Domains A1) • CD19 (CD19 Molecule) • CCND1 (Cyclin D1) • CD5 (CD5 Molecule) • FCER2 (Fc Fragment Of IgE Receptor II)
|
clonoSEQ
|
Venclexta (venetoclax) • Jaypirca (pirtobrutinib)
4ms
The Evolving Role of Bruton's Tyrosine Kinase Inhibitors in B Cell Lymphomas. (PubMed, Int J Mol Sci)
BTK signaling is implicated in various B-cell lymphomas such as mantle cell lymphoma, Waldenström Macroglobulinemia, follicular lymphoma, and diffuse large B cell lymphoma, leading to the development of transformative treatments like ibrutinib, the first-in-class covalent BTK inhibitor, and pirtobrutinib, the first-in-class noncovalent BTK inhibitor. This non-enzymatic role promotes cell survival and proliferation independently of kinase activity. Understanding BTK's dual roles unveils opportunities for therapeutics targeting its scaffolding function, promising advancements in disrupting lymphomagenesis and refining B cell lymphoma treatments.
Review • Journal • IO biomarker
|
LYN (LYN Proto-Oncogene Src Family Tyrosine Kinase) • SYK (Spleen tyrosine kinase) • TLR9 (Toll Like Receptor 9) • HCK (HCK Proto-Oncogene) • VCAM1 (Vascular Cell Adhesion Molecule 1)
|
Imbruvica (ibrutinib) • Jaypirca (pirtobrutinib)
4ms
Enrollment closed
|
Imbruvica (ibrutinib) • Jaypirca (pirtobrutinib)
4ms
New P2 trial • Combination therapy
|
Venclexta (venetoclax) • Rituxan (rituximab) • Jaypirca (pirtobrutinib)
4ms
Enrollment change
|
Jaypirca (pirtobrutinib)
4ms
Japanese regulatory • Journal
|
MET (MET proto-oncogene, receptor tyrosine kinase) • RET (Ret Proto-Oncogene)
|
Retevmo (selpercatinib) • Jaypirca (pirtobrutinib) • Haiyitan (gumarontinib) • Ezharmia (valemetostat) • Ojjaara (momelotinib) • Targretin oral (bexarotene oral)
5ms
Enrollment open
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib)
5ms
NCI-2024-00054: Glofitamab With Pirtobrutinib for Relapsed or Refractory Mantle Cell Lymphoma (clinicaltrials.gov)
P2; Not yet recruiting --> Recruiting | Trial completion date: Mar 2028 --> Jul 2028 | Trial primary completion date: Mar 2028 --> Jul 2028
Trial completion date • Trial primary completion date • Enrollment open
|
clonoSEQ
|
Gazyva (obinutuzumab) • Jaypirca (pirtobrutinib) • Columvi (glofitamab-gxbm)
5ms
Fixed-Duration Pirtobrutinib plus Venetoclax with or without Rituximab in Relapsed/Refractory CLL: Phase 1b BRUIN Trial. (PubMed, Blood)
P1/2; Adverse events led to dose reduction in 3 patients and discontinuation in 2. In conclusion, fixed-duration PV or PVR was well tolerated and had promising efficacy in patients with R/R CLL, including patients previously treated with a covalent BTKi.
Journal • P1 data
|
clonoSEQ
|
Venclexta (venetoclax) • Rituxan (rituximab) • Jaypirca (pirtobrutinib)
5ms
Current Approaches and Novel New Agents in the Treatment of Chronic Lymphocytic Leukemia. (PubMed, JCO Oncol Pract)
Randomized trials have demonstrated superiority of covalent bruton tyrosine kinase inhibitors (cBTKis) over CIT, and second-generation compounds such as acalabrutinib and zanubrutinib appear to have a more favorable efficacy/safety profile than ibrutinib. The noncovalent BTKi, pirtobrutinib, has shown impressive activity after failure of the cBTKis and is quite tolerable. The Bcl-2 inhibitor venetoclax plus a CD20, generally obinutuzumab, provides a high level of efficacy as initial treatment or after failure on a cBTKi, with many patients achieving a state of undetectable minimal residual disease. Promising novel approaches include BTK degraders, bispecific antibodies, and chimeric antigen receptor T-cell (CAR-T)-cell therapy. What is clear is that CIT is archaic, and current and future targeted approaches will continue to improve the outcome for patients with chronic lymphocytic leukemia.
Review • Journal
|
CD20 (Membrane Spanning 4-Domains A1)
|
Venclexta (venetoclax) • Imbruvica (ibrutinib) • Gazyva (obinutuzumab) • Brukinsa (zanubrutinib) • Calquence (acalabrutinib) • Jaypirca (pirtobrutinib)
6ms
Phase II Study of Pirtobrutinib, Rituximab (PR) in Previously Untreated Low and Intermediate Risk MCL (Mantle Cell Lymphoma) Patients (clinicaltrials.gov)
P2, N=50, Suspended, M.D. Anderson Cancer Center | Initiation date: Aug 2024 --> May 2024 | Not yet recruiting --> Suspended
Trial initiation date • Trial suspension
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib)
6ms
LOXO-BCL-20001: Study of Oral LOXO-338 in Patients With Advanced Blood Cancers (clinicaltrials.gov)
P1, N=316, Active, not recruiting, Eli Lilly and Company | Trial completion date: Dec 2023 --> Dec 2024
Trial completion date • Metastases
|
Jaypirca (pirtobrutinib) • FCN-338
6ms
A Review of Resistance Mechanisms to Bruton's Kinase Inhibitors in Chronic Lymphocytic Leukemia. (PubMed, Int J Mol Sci)
Ibrutinib is the first-in-class BTKi which has changed the treatment landscape of CLL. Over the last few years, novel, covalent (acalabrutinib, zanubrutinib), and non-covalent (pirtobrutinib) BTKi have been approved for the treatment of CLL...Moreover, novel mutations resulting in resistance to non-covalent BTKi have been recently suggested. This article summarizes the clinical efficacy and the latest data regarding resistance to all of the registered BTKi.
Review • Journal
|
TP53 (Tumor protein P53) • IGH (Immunoglobulin Heavy Locus) • PLCG2 (Phospholipase C Gamma 2)
|
Imbruvica (ibrutinib) • Brukinsa (zanubrutinib) • Calquence (acalabrutinib) • Jaypirca (pirtobrutinib)
6ms
LV20.19 CAR T-Cells in Combination With Pirtobrutinib for Relapsed, Refractory B-cell Malignancies (clinicaltrials.gov)
P1, N=12, Not yet recruiting, Medical College of Wisconsin | Trial completion date: Feb 2025 --> Jul 2027 | Initiation date: Apr 2024 --> Jul 2024 | Trial primary completion date: Nov 2024 --> Jul 2026
Trial completion date • Trial initiation date • Trial primary completion date • Combination therapy • CAR T-Cell Therapy
|
Jaypirca (pirtobrutinib) • CAR-20/19-T Cells
6ms
COMBINED PIRTOBRUTINIB, VENETOCLAX, AND OBINUTUZUMAB IN FIRST-LINE TREATMENT OF PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): A PHASE 2 TRIAL (EHA 2024)
Background: Treatment with combined covalent BTK-inhibitor (cBTKi such as ibrutinib, acalabrutinib, zanubrutinib) withBCL2-inhibitor, venetoclax +/- CD20 monoclonal antibody obinutuzumab showed high rates of undetectableMRD (U-MRD) remission in patients (pts) with CLL (Jain, NEJM 2019; Munir NEJM 2023; Wierda, JCO 2021; Kater, NEJM Evidence 2022). We report the first results for first-line combined pirtobrutinib, venetoclax, and obinutuzumab in pts with CLL. Avery high rate of bone marrow U-MRD at 10-6 sensitivity was noted at 6-months of combined treatment. Adverse event profile was similar to what was noted in previous studies with these agents.
P2 data • Clinical
|
TP53 (Tumor protein P53)
|
TP53 mutation • KRAS mutation • NOTCH1 mutation • Chr del(11q) • SF3B1 mutation • TP53 mutation + Chr del(17p) • Chr del(17p) + Chr del(11q) • TS 12
|
clonoSEQ
|
Venclexta (venetoclax) • Imbruvica (ibrutinib) • Gazyva (obinutuzumab) • Brukinsa (zanubrutinib) • Calquence (acalabrutinib) • Jaypirca (pirtobrutinib)
6ms
Trial primary completion date
|
Venclexta (venetoclax) • Rituxan (rituximab) • Jaypirca (pirtobrutinib) • Truxima (rituximab-abbs)
6ms
BRUIN-MCL-321: Study of BTK Inhibitor LOXO-305 Versus Approved BTK Inhibitor Drugs in Patients With Mantle Cell Lymphoma (MCL) (clinicaltrials.gov)
P3, N=500, Active, not recruiting, Loxo Oncology, Inc. | Recruiting --> Active, not recruiting | Trial completion date: Apr 2025 --> Jul 2026 | Trial primary completion date: Apr 2025 --> Dec 2025
Enrollment closed • Trial completion date • Trial primary completion date
|
Imbruvica (ibrutinib) • Brukinsa (zanubrutinib) • Calquence (acalabrutinib) • Jaypirca (pirtobrutinib)
6ms
BRUIN-CLL-314: A Study of Pirtobrutinib (LOXO-305) Versus Ibrutinib in Participants With Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL) (clinicaltrials.gov)
P3, N=650, Recruiting, Loxo Oncology, Inc. | Trial completion date: Mar 2029 --> Aug 2028 | Trial primary completion date: Mar 2028 --> Feb 2025
Trial completion date • Trial primary completion date
|
Imbruvica (ibrutinib) • Jaypirca (pirtobrutinib)
7ms
New P2 trial • Combination therapy
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib) • Mabtas (rituximab biosimilar)
7ms
Enrollment closed
|
Rituxan (rituximab) • Zydelig (idelalisib) • Jaypirca (pirtobrutinib) • bendamustine
7ms
Fixed Duration Pirtobrutinib and Obinutuzumab in Chronic Lymphocytic Leukemia (clinicaltrials.gov)
P2, N=60, Recruiting, Inhye Ahn | Not yet recruiting --> Recruiting | Initiation date: Sep 2024 --> Apr 2024
Enrollment open • Trial initiation date
|
Gazyva (obinutuzumab) • Jaypirca (pirtobrutinib)
7ms
Enrollment closed
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib) • bendamustine
8ms
A Study of Pirtobrutinib (LY3527727 [LOXO-305]) Versus Placebo in Participants With Relapsing Multiple Sclerosis (clinicaltrials.gov)
P2, N=0, Withdrawn, Loxo Oncology, Inc. | N=200 --> 0 | Not yet recruiting --> Withdrawn
Enrollment change • Trial withdrawal
|
Jaypirca (pirtobrutinib)
8ms
New P2 trial
|
Gazyva (obinutuzumab) • Jaypirca (pirtobrutinib)
8ms
BRUIN: A Study of Oral LOXO-305 in Patients With Previously Treated CLL/SLL or NHL (clinicaltrials.gov)
P1/2, N=860, Active, not recruiting, Loxo Oncology, Inc. | Trial completion date: Apr 2024 --> Jan 2028 | Trial primary completion date: Apr 2024 --> Sep 2027
Trial completion date • Trial primary completion date
|
Venclexta (venetoclax) • Rituxan (rituximab) • Jaypirca (pirtobrutinib)
8ms
Matching-Adjusted Indirect Comparison of Brexucabtagene Autoleucel (ZUMA-2) and Pirtobrutinib (BRUIN) in Patients with Relapsed/Refractory Mantle Cell Lymphoma Previously Treated with a Covalent Bruton Tyrosine Kinase Inhibitor. (PubMed, Adv Ther)
Findings suggest that brexu-cel may offer clinically and statistically significant benefits regarding objective response, complete response, and progression-free survival compared to pirtobrutinib among patients with R/R MCL after prior cBTKi therapy. Given the short follow-up and high degree of censoring in BRUIN, an analysis incorporating updated BRUIN data may provide more definitive overall survival results.
Journal
|
TP53 (Tumor protein P53)
|
TP53 mutation
|
Jaypirca (pirtobrutinib) • Tecartus (brexucabtagene autoleucel)
9ms
New P2 trial
|
Rituxan (rituximab) • Jaypirca (pirtobrutinib)
9ms
New P2 trial
|
clonoSEQ
|
Gazyva (obinutuzumab) • Jaypirca (pirtobrutinib) • Columvi (glofitamab-gxbm)
9ms
New P1 trial
|
Jaypirca (pirtobrutinib)
10ms
New P1 trial
|
Jaypirca (pirtobrutinib)