Common brand names

• Jaypirca

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 you miss a dose by more than 12 hours, skip the missed dose and take the next dose as scheduled.

How it works

Pirtobrutinib is a small molecule inhibitor that targets a protein called Bruton’s tyrosine kinase (BTK). BTK is important for the survival and growth of certain B-cells, a type of white blood cell involved in some blood cancers like mantle cell lymphoma (MCL). By blocking BTK, pirtobrutinib disrupts signals that help cancerous B-cells grow and survive.

Unlike some other BTK inhibitors, pirtobrutinib binds to both normal BTK and BTK with certain mutations (such as C481 mutations), which can make other treatments less effective. This means pirtobrutinib may work for patients whose cancer has stopped responding to other BTK inhibitors. In clinical studies, pirtobrutinib has shown the ability to reduce the number of cancer cells and shrink tumors in people with relapsed or refractory MCL.

Who should take it

Pirtobrutinib is indicated for adults with mantle cell lymphoma (MCL) who have relapsed or whose disease has not responded (refractory) after at least two previous lines of systemic therapy, including a BTK inhibitor. It is also approved for adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) who have received at least two prior therapies, including a BTK inhibitor and a BCL-2 inhibitor.

This medication is generally considered when other treatments have not worked or have stopped working. Your doctor will determine if pirtobrutinib is appropriate for you based on your treatment history and current health status.

Who should not take it

There are no absolute contraindications listed for pirtobrutinib. However, it should be used with caution in certain situations:

• Pregnant women should not take pirtobrutinib, as it can cause harm to an unborn baby. Women of childbearing potential should use effective contraception during treatment and for one week after the last dose.
• People with severe liver problems or those who develop drug-induced liver injury while on pirtobrutinib may need to stop the medication.
• Caution is advised in patients with a history of serious infections, bleeding disorders, heart rhythm problems, or other cancers.

Always discuss your full medical history with your healthcare provider before starting pirtobrutinib.

Commonly used with

Pirtobrutinib is usually used as a single agent (monotherapy) for mantle cell lymphoma after other treatments have failed. It may be used in patients who have previously received other BTK inhibitors, chemotherapy, or immunotherapy. Your doctor may recommend supportive medications to manage side effects or prevent infections while you are taking pirtobrutinib.

Commonly tested with

In clinical trials, pirtobrutinib has been tested in patients who have previously received other BTK inhibitors (such as ibrutinib, acalabrutinib, or zanubrutinib) and other therapies like chemotherapy, immunotherapy, or CAR-T cell therapy. It is being studied both as a single agent and in combination with other medications for blood cancers.