How it is administered

Pirtobrutinib is taken by mouth as a tablet. The recommended dose is 200 mg once daily, swallowed whole with water, with or without food. Tablets should not be cut, crushed, or chewed. If a dose is missed by more than 12 hours, skip the missed dose and take the next dose as scheduled.

How it works

Pirtobrutinib is a type of targeted therapy known as a Bruton tyrosine kinase (BTK) inhibitor. BTK is a protein that plays a key role in the signaling pathways of B-cells, which are a type of white blood cell involved in many blood cancers, including chronic lymphocytic leukemia (CLL). By blocking BTK, pirtobrutinib disrupts signals that help cancerous B-cells survive, grow, and spread.

Unlike some other BTK inhibitors, pirtobrutinib is a noncovalent (reversible) inhibitor and can bind to both normal BTK and BTK with certain mutations (such as C481 mutations) that may make other drugs less effective. This helps stop the growth of cancerous B-cells, leading to a reduction in disease activity. In clinical studies, pirtobrutinib has shown the ability to shrink tumors and control disease in patients who have already received other treatments, including other BTK inhibitors.

Who Should take it

Pirtobrutinib is indicated for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have already received at least two prior lines of therapy, including a BTK inhibitor and a BCL-2 inhibitor. It is also approved for adults with mantle cell lymphoma (MCL) who have relapsed or are refractory after at least two lines of systemic therapy, including a BTK inhibitor.

This medication is typically considered when other standard treatments have not worked or have stopped working. Your healthcare provider will determine if pirtobrutinib is right for you based on your treatment history and specific type of blood cancer.

Who should not take it

There are no absolute contraindications listed for pirtobrutinib. However, patients who are pregnant should not take this medication, as it can cause harm to an unborn baby. Women of reproductive potential should use effective contraception during treatment and for at least one week after the last dose.

Caution is advised in patients with a history of severe infections, bleeding disorders, liver problems, or heart rhythm disturbances. Your doctor will monitor you closely and may adjust your dose or stop treatment if serious side effects occur.

Commonly used with

Pirtobrutinib is often used as a single agent, especially in patients who have already received other therapies. It may be used after other BTK inhibitors and BCL-2 inhibitors, particularly in patients with CLL/SLL or MCL who have relapsed or are refractory to previous treatments.

Your doctor may also recommend supportive medications to help prevent infections or manage side effects, depending on your individual risk factors.

Commonly tested with

In clinical studies, pirtobrutinib has been tested in patients who have previously received other BTK inhibitors (such as ibrutinib, acalabrutinib, or zanubrutinib) and BCL-2 inhibitors (such as venetoclax). It is being studied both as a single agent and in combination with other therapies for blood cancers.

Your healthcare team will determine the best treatment plan for you based on your prior therapies and current health status.