Lilly's Jaypirca (pirtobrutinib) recommended by CHMP for approval in the European Union for adults with relapsed or refractory chronic lymphocytic leukemia (CLL) previously treated with a BTK inhibitor
Eli Lilly's (LLY) Jaypirca (pirtobrutinib) received a positive recommendation from EMA's CHMP for treating adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who were previously treated with a BTK inhibitor.
The recommendation is based on the Phase 3 BRUIN CLL-321 trial results, which demonstrated that Jaypirca reduced disease progression or death risk by 46% compared to standard treatments (median PFS: 14.0 vs. 8.7 months). The median time to next treatment improved by 63% (24 months vs. 11 months).
The trial showed consistent results across key subgroups, including patients with poor prognosis factors. Common adverse reactions included neutropenia, fatigue, diarrhea, anemia, rash, and contusion. The European Commission's final decision is expected within 1-2 months.
Eli Lilly's (LLY) Jaypirca (pirtobrutinib) ha ricevuto una raccomandazione positiva dal CHMP dell'EMA per il trattamento di pazienti adulti con leucemia linfatica cronica (CLL) recidivante o refrattaria che erano stati precedentemente trattati con un inibitore BTK.
La raccomandazione si basa sui risultati dello studio di fase 3 BRUIN CLL-321, che ha dimostrato che Jaypirca ha ridotto il rischio di progressione della malattia o morte del 46% rispetto ai trattamenti standard (mediana PFS: 14,0 vs. 8,7 mesi). Il tempo mediano fino al prossimo trattamento è migliorato del 63% (24 mesi vs. 11 mesi).
Lo studio ha mostrato risultati coerenti tra i principali sottogruppi, inclusi i pazienti con fattori di prognosi sfavorevole. Le reazioni avverse comuni includevano neutropenia, affaticamento, diarrea, anemia, eruzione cutanea e contusioni. La decisione finale della Commissione Europea è attesa entro 1-2 mesi.
Eli Lilly's (LLY) Jaypirca (pirtobrutinib) recibió una recomendación positiva del CHMP de la EMA para tratar a pacientes adultos con leucemia linfocítica crónica (CLL) en recaída o refractaria que habían sido tratados previamente con un inhibidor de BTK.
La recomendación se basa en los resultados del ensayo de fase 3 BRUIN CLL-321, que demostró que Jaypirca redujo el riesgo de progresión de la enfermedad o muerte en un 46% en comparación con los tratamientos estándar (mediana PFS: 14.0 vs. 8.7 meses). El tiempo mediano hasta el próximo tratamiento mejoró en un 63% (24 meses vs. 11 meses).
El ensayo mostró resultados consistentes en los principales subgrupos, incluidos los pacientes con factores de mal pronóstico. Las reacciones adversas comunes incluyeron neutropenia, fatiga, diarrea, anemia, erupción cutánea y contusiones. Se espera que la decisión final de la Comisión Europea se tome en 1-2 meses.
엘리 릴리 (LLY)의 제이피르카 (피르토브루틴)은 BTK 억제제로 이전에 치료받은 만성 림프구성 백혈병 (CLL) 재발 또는 불응성 성인 환자를 치료하기 위해 EMA의 CHMP로부터 긍정적인 추천을 받았습니다.
이 추천은 3상 BRUIN CLL-321 시험 결과를 기반으로 하며, 제이피르카가 표준 치료에 비해 질병 진행 또는 사망 위험을 46% 감소시켰음을 보여주었습니다 (중앙 PFS: 14.0 대 8.7개월). 다음 치료까지의 중앙 시간은 63% 개선되었습니다 (24개월 대 11개월).
시험은 불리한 예후 인자를 가진 환자를 포함한 주요 하위 그룹에서 일관된 결과를 보였습니다. 일반적인 부작용으로는 호중구감소증, 피로, 설사, 빈혈, 발진 및 타박상이 포함되었습니다. 유럽연합 집행위원회의 최종 결정은 1-2개월 이내에 예상됩니다.
Eli Lilly's (LLY) Jaypirca (pirtobrutinib) a reçu une recommandation positive du CHMP de l'EMA pour le traitement des patients adultes atteints de leucémie lymphoïde chronique (LLC) en rechute ou réfractaire ayant été précédemment traités par un inhibiteur de BTK.
Cette recommandation est basée sur les résultats de l', qui a démontré que Jaypirca réduisait le risque de progression de la maladie ou de décès de 46 % par rapport aux traitements standards (PFS médian : 14,0 contre 8,7 mois). Le temps médian jusqu'au prochain traitement s'est amélioré de 63 % (24 mois contre 11 mois).
L'essai a montré des résultats cohérents dans les principaux sous-groupes, y compris les patients présentant des facteurs de pronostic défavorable. Les réactions indésirables courantes comprenaient la neutropénie, la fatigue, la diarrhée, l'anémie, l'éruption cutanée et les contusions. La décision finale de la Commission européenne est attendue dans un délai de 1 à 2 mois.
Eli Lilly's (LLY) Jaypirca (pirtobrutinib) erhielt eine positive Empfehlung des CHMP der EMA zur Behandlung von erwachsenen Patienten mit rezidivierender oder refraktärer chronischer lymphatischer Leukämie (CLL), die zuvor mit einem BTK-Hemmer behandelt wurden.
Die Empfehlung basiert auf den Ergebnissen der Phase-3-Studie BRUIN CLL-321, die zeigte, dass Jaypirca das Risiko für Krankheitsprogression oder Tod um 46 % im Vergleich zu Standardbehandlungen reduzierte (medianes PFS: 14,0 vs. 8,7 Monate). Die mediane Zeit bis zur nächsten Behandlung verbesserte sich um 63 % (24 Monate vs. 11 Monate).
Die Studie zeigte konsistente Ergebnisse in den wichtigsten Untergruppen, einschließlich Patienten mit ungünstigen Prognosefaktoren. Häufige Nebenwirkungen umfassten Neutropenie, Müdigkeit, Durchfall, Anämie, Hautausschlag und Blutergüsse. Die endgültige Entscheidung der Europäischen Kommission wird in 1-2 Monaten erwartet.
- 46% reduction in disease progression/death risk vs standard treatment
- 63% improvement in time to next treatment (24 vs 11 months)
- Consistent efficacy across poor prognosis subgroups
- Potential expansion into new market (EU) for CLL treatment
- Median PFS of 14 months indicates duration of effectiveness
- Multiple adverse reactions reported including neutropenia and anemia
Insights
The CHMP's positive opinion for Jaypirca (pirtobrutinib) represents a significant advancement in CLL treatment, particularly for patients who have progressed after initial BTK inhibitor therapy. The Phase 3 BRUIN CLL-321 data demonstrates 46% reduction in disease progression or death risk and extends median progression-free survival to 14.0 months versus 8.7 months with standard treatments.
What's clinically groundbreaking is Jaypirca's novel mechanism as a non-covalent (reversible) BTK inhibitor, allowing it to maintain efficacy after covalent BTK inhibitor failure - a common treatment challenge. The 24-month median time to next treatment (versus 11 months) indicates substantially improved disease control duration, a critical metric for CLL patients who often require sequential therapies.
Particularly impressive is Jaypirca's consistent efficacy across high-risk subgroups with traditionally poor prognoses, including those with TP53 mutations, 17p deletions, unmutated IGHV status, and complex karyotype. These populations typically respond poorly to conventional therapies, making this a meaningful clinical advance for the most challenging cases.
This CHMP recommendation positions Lilly to potentially lead in the post-BTK inhibitor CLL treatment landscape, addressing a growing market segment as more patients progress through first-line BTK inhibitor therapy. European Commission approval, expected within 1-2 months, would make the EU the first major market to approve Jaypirca specifically for post-BTK CLL patients.
Lilly has strategically built Jaypirca's indications, with this CLL expansion complementing its existing conditional EU approval in mantle cell lymphoma and U.S. approvals in both MCL and CLL/SLL. The company's ongoing global regulatory submissions indicate confidence in the drug's commercial potential across hematologic malignancies.
The BRUIN CLL-321 trial's distinction as the first randomized Phase 3 study in post-BTK inhibitor CLL patients gives Lilly first-mover advantage with robust clinical evidence in this specific population. This positions Jaypirca as potentially practice-changing in a therapeutic area with established competitors but options after BTK inhibitor failure.
For Lilly, this approval would strengthen their oncology portfolio diversification beyond their traditional metabolic and immunology focus, representing continued execution on their long-term strategy to expand presence in high-value specialty markets.
The positive opinion is based on results from the Phase 3 BRUIN CLL-321 trial, recently presented at the 2024 American Society of Hematology Annual Meeting
BRUIN CLL-321 is the first randomized Phase 3 study in CLL ever conducted exclusively in patients previously treated with a BTK inhibitor
"Results from the BRUIN CLL-321 trial show that Jaypirca delivers clinically meaningful outcomes in a post-BTK inhibitor setting with markedly prolonged time to next treatment, including in those with high-risk characteristics often associated with poor prognosis," said Paolo Ghia, M.D., professor, medical oncology, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele,
Following this positive opinion, the application for the use of Jaypirca in patients with relapsed or refractory CLL who have been previously treated with a BTK inhibitor is now referred to the European Commission for final action. The European Commission's decision is expected in the next one to two months. Jaypirca has also previously received a conditional marketing authorization by the EMA for the treatment of adult patients with relapsed or refractory mantle cell lymphoma (MCL) who have been previously treated with a BTK inhibitor.
The positive opinion is supported by data from the BRUIN CLL-321 clinical trial, the first randomized Phase 3 study in CLL ever conducted exclusively in patients previously treated with a BTK inhibitor. The study's primary endpoint of progression-free survival (PFS) was met at the prespecified time of final analysis (Aug. 29, 2023), based on independent review committee (IRC) assessment, demonstrating pirtobrutinib was superior to investigator's choice of idelalisib plus rituximab (IdelaR) or bendamustine plus rituximab (BR), both global standards of care.1 At an updated analysis (Aug. 29, 2024), pirtobrutinib reduced the risk of disease progression or death by
Results from the BRUIN CLL-321 study were presented at the American Society of Hematology (ASH) Annual Meeting and Exposition in December 2024.
"We are pleased to receive a positive opinion from the CHMP, signaling that the European Union may lead the way in broadening patient access to Jaypirca for those with relapsed or refractory CLL in the post-BTK inhibitor setting," said Jacob Van Naarden, executive vice president and president of Lilly Oncology. "There are currently no treatment options that have been specifically studied in a randomized Phase 3 trial in this patient population, and we are hopeful Jaypirca will be a meaningful new option for patients. We look forward to the European Commission's decision in the coming months."
In addition to this positive opinion in CLL and conditional approval in MCL in the EU, Jaypirca was approved in the
About BRUIN CLL-321
BRUIN CLL-321 is a Phase 3, randomized, open-label study of pirtobrutinib versus investigator's choice of idelalisib plus rituximab (IdelaR) or bendamustine plus rituximab (BR) in BTK inhibitor pre-treated patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). The trial enrolled 238 patients, who were randomized 1:1 to receive pirtobrutinib (200 mg orally, once daily) or investigator's choice of either IdelaR or BR per labeled doses. This trial's primary endpoint is progression-free survival (PFS) per 2018 International Workshop on Chronic Lymphocytic Leukemia (iwCLL) criteria, as assessed by blinded independent review committee (IRC). Secondary endpoints include PFS, as assessed by investigator; overall response rate (ORR) and duration of response (DoR); event-free survival; overall survival (OS) and time to next treatment (TTNT); safety and tolerability; and patient-reported outcomes (PRO).
About Jaypirca (pirtobrutinib)
Jaypirca (pirtobrutinib, formerly known as LOXO-305) (pronounced jay-pihr-kaa) is a highly selective (300 times more selective for BTK versus
About Chronic Lymphocytic Leukemia (CLL)
CLL is a form of slow-growing non-Hodgkin lymphoma that develops from white blood cells known as lymphocytes.5,6 CLL is one of the most common types of leukemia in adults.5 There are roughly 100,000 new cases of CLL globally each year, and the overall incidence of CLL in
INDICATIONS FOR JAYPIRCA (pirtobrutinib) (in
Jaypirca is a kinase inhibitor indicated for the treatment of
- Adult patients with relapsed or refractory mantle cell lymphoma (MCL) after at least two lines of systemic therapy, including a BTK inhibitor.
- Adult patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) who have received at least two prior lines of therapy, including a BTK inhibitor and a BCL-2 inhibitor.
These indications are approved under accelerated approval based on response rate. Continued approval for these indications may be contingent upon verification and description of clinical benefit in a confirmatory trial.
IMPORTANT SAFETY INFORMATION FOR JAYPIRCA (pirtobrutinib)
Infections: Fatal and serious infections (including bacterial, viral, fungal) and opportunistic infections occurred in Jaypirca-treated patients. In a clinical trial, Grade ≥3 infections occurred in
Hemorrhage: Fatal and serious hemorrhage has occurred with Jaypirca. Major hemorrhage (Grade ≥3 bleeding or any central nervous system bleeding) occurred in
Cytopenias: Jaypirca can cause cytopenias, including neutropenia, thrombocytopenia, and anemia. In a clinical trial, Grade 3 or 4 cytopenias, including decreased neutrophils (
Cardiac Arrhythmias: Cardiac arrhythmias occurred in patients who received Jaypirca. In a clinical trial of patients with hematologic malignancies, atrial fibrillation or flutter were reported in
Second Primary Malignancies: Second primary malignancies, including non-skin carcinomas, developed in
Hepatotoxicity, Including Drug-Induced Liver Injury (DILI): Hepatotoxicity, including severe, life-threatening, and potentially fatal cases of DILI, has occurred in patients treated with BTK inhibitors, including Jaypirca. Evaluate bilirubin and transaminases at baseline and throughout Jaypirca treatment. For patients who develop abnormal liver tests after Jaypirca, monitor more frequently for liver test abnormalities and clinical signs and symptoms of hepatic toxicity. If DILI is suspected, withhold Jaypirca. Upon confirmation of DILI, discontinue Jaypirca.
Embryo-Fetal Toxicity: Jaypirca can cause fetal harm in pregnant women. Administration of pirtobrutinib to pregnant rats caused embryo-fetal toxicity, including embryo-fetal mortality and malformations at maternal exposures (AUC) approximately 3-times the recommended 200 mg/day dose. Advise pregnant women of potential fetal risk and females of reproductive potential to use effective contraception during treatment and for one week after last dose.
Adverse Reactions (ARs) in Patients Who Received Jaypirca
The most common (≥
Mantle Cell Lymphoma
Serious ARs occurred in
Dose Modifications and Discontinuations: ARs led to dose reductions in
Most common ARs (≥
Select Laboratory Abnormalities (all Grades %; Grade 3 or 4 %) that Worsened from Baseline in ≥
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Serious ARs occurred in
Dose Modifications and Discontinuations: ARs led to dose reductions in
Most common ARs (≥
Select Laboratory Abnormalities (all Grades %; Grade 3 or 4 %) that Worsened from Baseline in ≥
Drug Interactions
Strong CYP3A Inhibitors: Concomitant use with Jaypirca increased pirtobrutinib systemic exposure, which may increase risk of Jaypirca ARs. Avoid use of strong CYP3A inhibitors with Jaypirca. If concomitant use is unavoidable, reduce Jaypirca dosage according to approved labeling.
Strong or Moderate CYP3A Inducers: Concomitant use with Jaypirca decreased pirtobrutinib systemic exposure, which may reduce Jaypirca efficacy. Avoid concomitant use of Jaypirca with strong or moderate CYP3A inducers. If concomitant use with moderate CYP3A inducers is unavoidable, increase Jaypirca dosage according to approved labeling.
Sensitive CYP2C8, CYP2C19, CYP3A, P-gp, or BCRP Substrates: Concomitant use with Jaypirca increased their plasma concentrations, which may increase risk of adverse reactions related to these substrates for drugs that are sensitive to minimal concentration changes. Follow recommendations for these sensitive substrates in their approved labeling.
Use in Special Populations
Pregnancy and Lactation: Due to potential for Jaypirca to cause fetal harm, verify pregnancy status in females of reproductive potential prior to starting Jaypirca and advise use of effective contraception during treatment and for one week after last dose. Presence of pirtobrutinib in human milk is unknown. Advise women not to breastfeed while taking Jaypirca and for one week after last dose.
Geriatric Use: In the pooled safety population of patients with hematologic malignancies, patients aged ≥65 years experienced higher rates of Grade ≥3 ARs and serious ARs compared to patients <65 years of age.
Renal Impairment: Severe renal impairment increases pirtobrutinib exposure. Reduce Jaypirca dosage in patients with severe renal impairment according to approved labeling.
PT HCP ISI MCL_CLL AA JUN2024
Please see Prescribing Information and Patient Information for Jaypirca.
About Lilly
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Cautionary Statement Regarding Forward-Looking Statements
This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Jaypirca (pirtobrutinib), as a potential treatment for adults with chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) who have been previously treated with a BTK inhibitor and as a treatment for adult patients with relapsed or refractory mantle cell lymphoma (MCL) after at least two lines of systemic therapy, including a BTK inhibitor and the timeline for future readouts, presentations, and other milestones relating to Jaypirca and its clinical trials, and reflects Lilly's current beliefs and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of drug research, development, and commercialization. Among other things, there is no guarantee that planned or ongoing studies will be completed as planned, that future study results will be consistent with study results to date, that Jaypirca will receive regulatory approval, or that Lilly will execute its strategy as expected. For further discussion of these and other risks and uncertainties that could cause actual results to differ from Lilly's expectations, see Lilly's Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release.
- Sharman JP, Munir T, Grosicki S, et al. 886 BRUIN CLL-321: Randomized Phase III Trial of Pirtobrutinib Versus Idelalisib Plus Rituximab (IdelaR) or Bendamustine Plus Rituximab (BR) in BTK Inhibitor Pretreated Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Abstract presented at: American Society of Hematology Annual Meeting and Exposition; December 9, 2024;
San Diego, CA. Session 642. - Mato AR, Shah NN, Jurczak W, et al. Pirtobrutinib in relapsed or refractory B-cell malignancies (BRUIN): a phase 1/2 study. Lancet. 2021;397(10277):892-901. doi:10.1016/S0140-6736(21)00224-5
- Hanel W, Epperla N. Emerging therapies in mantle cell lymphoma. J Hematol Oncol. 2020;13(1):79. Published 2020 Jun 17. doi:10.1186/s13045-020-00914-1
- Gu D, Tang H, Wu J, Li J, Miao Y. Targeting Bruton tyrosine kinase using non-covalent inhibitors in B cell malignancies. J Hematol Oncol. 2021;14(1):40. Published 2021 Mar 6. doi:10.1186/s13045-021-01049-7
- Mukkamalla SKR, Taneja A, Malipeddi D, et al. Chronic Lymphocytic Leukemia. [Updated 2023 Feb 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470433/
- The Leukemia and Lymphoma Society. NHL Subtypes. Access here: https://www.lls.org/lymphoma/non-hodgkin-lymphoma/nhl-subtypes. Accessed on October 25, 2023.
- Ou Y, Long Y, Ji L, et al. Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study. Front Oncol. 2022;12:840616. Published 2022 Mar 10. doi:10.3389/fonc.2022.840616
- Sant M, et al. Incidence of hematologic malignancies in
Europe by morphologic subtype: results of the HAEMACARE project. Blood. 2010. 116:3724–34. https://pubmed.ncbi.nlm.nih.gov/20664057/
Refer to: | Kyle Owens; owens_kyle@lilly.com; 332-259-3932 (Media) |
Michael Czapar; czapar_michael_c@lilly.com; 317-617-0983 (Investors) |
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