INDIANAPOLIS, Oct. 2, 2026 /PRNewswire/ --Eli Lilly and Company(NYSE: LLY) announced today that the U.S. Food and Drug Administration(FDA) has approved an additional indication for Jaypirca (pirtobrutinib, 100 mg & 50 mg tablets), a non-covalent Bruton tyrosine kinase (BTK) inhibitor, for the treatment of adult patients with previously untreated chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) with no known 17p deletion. This approval allows for the use of Jaypirca as a first-line treatment for appropriate patients.
"This approval is grounded in data from BRUIN CLL-313, which showed a significant delay in disease progression for pirtobrutinib compared to chemoimmunotherapy, along with safety and tolerability consistent with its established profile," saidJennifer A. Woyach, M.D., professor, hematologist-oncologist, and Director of theDivision of HematologyatThe Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. "Doctors can now consider pirtobrutinib for appropriate patients when initial therapy is needed, not just later in a patient's treatment journey. Given the efficacy and tolerability of modern targeted therapies – coupled with factors like age or comorbidity – many people diagnosed with CLL or SLL today may only receive one or two lines of therapy, making initial treatment choices critically important."
The labeling for Jaypirca contains warnings and precautions for infections, hemorrhage, cytopenias, cardiac arrhythmias, second primary malignancies, hepatotoxicity including drug-induced liver injury and embryo-fetal toxicity. See Important Safety Information below and full Prescribing Information for additional information, including dosing modifications.
Jaypirca, the first-and-onlyFDA-approved non-covalent BTK inhibitor, is a highly selective kinase inhibitor that utilizes a novel non-covalent binding mechanism to target the BTK pathway in patients with CLL/SLL.1,2
TheFDAapproval is based on results from the primary analysis of the BRUIN CLL-313 clinical trial, which were presented at theAmerican Society of HematologyAnnual Meeting and Exposition inDecember 2025and published in The Journal of Clinical Oncology.3 BRUIN CLL-313 is the first prospective, randomized Phase 3 study to examine the efficacy and safety of a non-covalent BTK inhibitor in patients with previously untreated CLL/SLL without 17p deletion.
In BRUIN CLL-313, at a median follow-up of 28 months, the primary endpoint of Independent Review Committee (IRC)-assessed progression-free survival (PFS) was significantly improved with pirtobrutinib (n=141) compared to bendamustine plus rituximab (BR) (n=141) (HR=0.20 [95% CI, 0.11–0.37]; p<0.0001), and the median PFS was not yet reached for pirtobrutinib compared to 33.5 months for BR.4 IRC-assessed overall response rate (ORR) was 94% (95% CI, 89–98) in the pirtobrutinib arm (complete response [CR]=13%; partial response [PR]=81%) and 81% (95% CI, 73–87) in the BR arm (CR=21%; PR=60%). In the BRUIN CLL-313 trial, adverse reactions (ARs) led to dose reductions in 3.6% and permanent discontinuation of Jaypirca in 4.3% of patients. Serious ARs occurred in 28% of patients who received Jaypirca. Serious ARs occurring in ≥3% of patients included pneumonia (5%). The overall safety profile, including rates of atrial fibrillation or flutter, for patients treated with pirtobrutinib in the BRUIN CLL-313 trial was consistent with previously reported trials across treatment settings.
"This additional approval for Jaypirca, based on BRUIN CLL-313, marks a significant step forward, expanding its potential to reach more patients who may benefit – this time as an initial treatment for certain previously untreated patients with CLL or SLL," saidJacob Van Naarden, executive vice president and president ofLillyOncology. "This milestone underscores Jaypirca's versatility in the CLL continuum of care, from the first-line setting for appropriate patients to its valuable role in the relapsed or refractory post-covalent BTK inhibitor setting, reinforcing Jaypirca's broad applicability as a meaningful treatment option for people with CLL or SLL."
Jaypirca is the first-and-only non-covalent BTK inhibitor recommended by the National Comprehensive Cancer Network® (NCCN®).1,5,6,7 Jaypirca is Category 2A recommended for treatment-naïve adult patients with CLL/SLL without del(17p), recommended for older patients with cardiac comorbidities who may only need one lifetime treatment for CLL/SLL.8 Jaypirca is a Category 1 preferred option for adult patients with relapsed or refractory CLL/SLL who have previously been treated with a covalent BTK inhibitor. Please see full NCCN guidelines for more information.
Lillyis studying Jaypirca in CLL/SLL in multiple Phase 3 studies. Details on the trials can be found by visiting clinicaltrials.gov.
See Important Safety Information below and full Prescribing Information for additional information.
Click here to view the CLL infographic.
About the BRUIN Clinical Development Program
The BRUIN clinical development program comprises four positive Phase 3 studies evaluating pirtobrutinib across multiple lines of CLL/SLL:
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BRUIN CLL-313 is the first prospective, randomized Phase 3 study to examine the efficacy and safety of a non-covalent BTK inhibitor in patients with previously untreated CLL without 17p deletion. The BRUIN CLL-313 study is evaluating pirtobrutinib versus chemoimmunotherapy (BR) in patients with CLL/SLL without 17p deletion who have not been previously treated.
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BRUIN CLL-314 is the first head-to-head Phase 3 CLL trial to compare covalent and non-covalent BTK inhibitors in a BTKi-naïve population, which included relapsed and refractory and treatment-naïve patients. The BRUIN CLL-314 study is evaluating pirtobrutinib versus ibrutinib in patients with CLL/SLL who were either treatment-naïve, or who were previously treated and were BTK inhibitor-naïve.
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BRUIN CLL-321 is the first randomized Phase 3 study in CLL in which all patients were previously treated with a covalent BTK inhibitor. The BRUIN CLL-321 study is evaluating pirtobrutinib versus investigator's choice of idelalisib plus rituximab (IdelaR) or BR in covalent BTK inhibitor pre-treated patients with relapsed and refractory CLL/SLL.
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BRUIN CLL-322 is the first Phase 3 readout in CLL to utilize a venetoclax-containing control arm. The BRUIN CLL-322 study is evaluating time-limited pirtobrutinib plus venetoclax and rituximab versus venetoclax and rituximab in previously treated CLL/SLL patients.
About BRUIN CLL-313
BRUIN CLL-313 (NCT05023980) is a Phase 3, global, randomized, open-label study of Jaypirca (pirtobrutinib) versus chemoimmunotherapy (BR) in people with CLL/SLL without 17p deletion who have not been previously treated. The trial enrolled 282 patients who were randomized 1:1 to receive pirtobrutinib (200 mg orally, once daily until disease progression or unacceptable toxicity) or BR per labeled doses. BR is a chemoimmunotherapy regimen used in the treatment of CLL. The primary endpoint is PFS as assessed by blinded IRC. Secondary endpoints include investigator and IRC-assessed ORR and duration of response (DoR), investigator-assessed PFS, overall survival (OS), 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 98% of other kinases tested in preclinical studies), non-covalent inhibitor of the enzyme BTK, and is the first-and-only approved non-covalent BTK inhibitor binding to both wild-type and C481 mutated BTK.2 BTK is a validated molecular target found across numerous B-cell leukemias and lymphomas including mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL).9,10 Jaypirca is aU.S.FDA-approved oral prescription medicine, 100 mg or 50 mg tablets taken as a once-daily 200 mg dose with or without food until disease progression or unacceptable toxicity.
About Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
CLL and SLL are forms of slow-growing non-Hodgkin lymphoma that develop from white blood cells known as lymphocytes.11 CLL is one of the most common types of leukemia in adults.11 In theU.S., CLL accounts for about one-quarter of the new cases of leukemia and there will be approximately 22,760 new cases of CLL diagnosed this year.11,12 SLL is identical to CLL from a pathologic and immunophenotypic standpoint, with the main difference between them being the location of the cancer cells.11 In CLL, the cancer cells are present in the blood, and in SLL, the cancer cells are found in the lymph nodes.11
About Lilly
Lilly is a medicine company turning science into healing to make life better for people around the world. We've been pioneering life-changing discoveries for 150 years, and today our medicines help tens of millions of people across the globe. Harnessing the power of biotechnology, chemistry and genetic medicine, our scientists are urgently advancing new discoveries to solve some of the world's most significant health challenges: redefining diabetes care; treating obesity and curtailing its most devastating long-term effects; advancing the fight against Alzheimer's disease; providing solutions to some of the most debilitating immune system disorders; and transforming the most difficult-to-treat cancers into manageable diseases. With each step toward a healthier world, we're motivated by one thing: making life better for millions more people. That includes delivering innovative clinical trials that reflect the diversity of our world and working to ensure our medicines are accessible and affordable.
Endnotes & References
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Jaypirca. Prescribing Information. Lilly USA, LLC.
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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
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Jurczak W, Kwiatek M, Czyz J, et al. BRUIN CLL-313: Randomized Phase III Trial of Pirtobrutinib Versus Bendamustine Plus Rituximab in Untreated Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. J Clin Oncol. 2026;44(6):466-475. doi:10.1200/JCO-25-02380
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Based on Kaplan-Meier estimation.
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Lilly does not recommend use outside of its approved indications. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.6 To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN Defines: Category 1: Based upon high-level evidence (≥1randomized phase 3 trials or high-quality, robust meta-analyses), there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate. Preferred intervention: interventions that are based on superior efficacy, safety, and evidence; and, when appropriate, affordability.
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Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma V2.2027 ©National Comprehensive Cancer Network, Inc. 2026. All rights reserved. Accessed September 30, 2026. To view the most recent and complete version of the guidelines, go online to NCCN.org
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NCCN Category recommendations for pirtobrutinib do not differ based on del(17p) and/or TP53 mutation status.
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There are no available data on optimal sequencing of therapy for patients with disease progression on pirtobrutinib and development of cross resistance to covalent BTK inhibitor.
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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
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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
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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/
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National Cancer Institute. Cancer Stat Facts: Leukemia — Chronic Lymphocytic Leukemia (CLL). https://seer.cancer.gov/statfacts/html/clyl.html
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Hallek M. Chronic Lymphocytic Leukemia: 2025 Update on the Epidemiology, Pathogenesis, Diagnosis, and Therapy. Am J Hematol. 2025;100(3):450-480. doi:10.1002/ajh.27546