Lilly's Jaypirca (pirtobrutinib) met its primary endpoint in first-of-its-kind, head-to-head Phase 3 study versus Imbruvica (ibrutinib)
Rhea-AI Summary
Lilly (NYSE: LLY) announced Phase 3 BRUIN CLL-314 results showing Jaypirca (pirtobrutinib) met the primary endpoint of non-inferiority for overall response rate (ORR) versus Imbruvica (ibrutinib) in CLL/SLL (ITT ORR 87.0% vs 78.5%; nominal p=0.0035; 95% CIs reported).
PFS was immature but trended toward pirtobrutinib across populations (ITT HR=0.569) with a 76% reduction in risk of progression or death in the treatment-naïve subgroup (HR=0.239). Safety signals favored pirtobrutinib on atrial fibrillation/flutter (2.4% vs 13.5%) and hypertension (10.6% vs 15.1%). Data to be published in Journal of Clinical Oncology and presented at ASH 2025.
Positive
- IRC-assessed ORR 87.0% with pirtobrutinib (ITT)
- ORR difference versus ibrutinib: 87.0% vs 78.5%
- Treatment-naïve PFS HR=0.239 (76% risk reduction)
- Lower atrial fibrillation/flutter rate: 2.4% vs 13.5%
- Fewer AE-related dose reductions: 7.9% vs 18.2%
Negative
- PFS data immature; formal superiority test pending
- Overall survival showed no benefit (HR=0.961)
- Median follow-up limited: 18.4–22.5 months across groups
Key Figures
Market Reality Check
Peers on Argus
LLY was down 0.41% with major pharma peers such as NVO, NVS and ABBV also negative (e.g., NVO -2.21%, ABBV -1.24%), but no peers appeared in the momentum scanner, suggesting a stock-specific rather than confirmed sector-wide move.
Historical Context
| Date | Event | Sentiment | Move | Catalyst |
|---|---|---|---|---|
| 2025-12-03 | FDA approval | Positive | -1.2% | Jaypirca FDA traditional approval and expanded CLL/SLL indication. |
| 2025-11-24 | Conference data | Positive | +3.7% | Breast cancer program updates for Inluriyo, Verzenio and other assets. |
| 2025-11-24 | Clinical trial data | Positive | +1.0% | Positive Phase 3 Jaypirca BRUIN CLL-314 and CLL-313 topline results preview. |
| 2025-11-19 | Strategic expansion | Positive | +1.9% | Announcement of new Lilly Gateway Labs site in Philadelphia. |
| 2025-11-18 | Conference participation | Positive | +0.8% | Planned appearance at Citi’s 2025 Global Healthcare Conference. |
Recent drug and trial news for LLY has generally seen modest positive price reactions, with one notable FDA approval event drawing a small negative move.
Over the last few months, LLY has reported multiple positive milestones across oncology, metabolic disease and other franchises. Notably, Jaypirca’s label was expanded by the FDA on 2025-12-03 with a -1.2% move, while earlier BRUIN CLL-314/313 preview data on 2025-11-24 saw a 0.99% gain. Additional positive Phase 2 and Phase 3 readouts in obesity, diabetes and alopecia drove smaller up moves between 0.37% and 1.75%. Today’s detailed BRUIN CLL-314 results build directly on the November ASH preview for Jaypirca.
Market Pulse Summary
This announcement provides mature Phase 3 BRUIN CLL-314 data showing higher ORR 87.0% for pirtobrutinib versus 78.5% for ibrutinib and favorable trends in PFS and safety. It builds on earlier ASH topline disclosures and the recent FDA label expansion for Jaypirca. Investors may focus on how CLL/SLL performance complements LLY’s broader late-stage pipeline and the durability of its premium valuation, while monitoring upcoming BRUIN CLL-313 results and additional regulatory milestones.
Key Terms
overall response rate medical
progression-free survival medical
intent-to-treat medical
hazard ratio medical
treatment-emergent adverse events medical
AI-generated analysis. Not financial advice.
In addition to meeting the primary endpoint of non-inferiority for overall response rate (ORR) in the BRUIN CLL-314 study, pirtobrutinib achieved a numerically higher ORR of
Progression-free survival data were immature but trended in favor of pirtobrutinib with a
These data will be simultaneously published in the Journal of Clinical Oncology and presented at the 2025 American Society of Hematology Annual Meeting and Exposition, as well as featured as part of the meeting's press program
These data will be highlighted at the 67th American Society of Hematology (ASH) Annual Meeting and Exposition taking place in
"These data from BRUIN CLL-314 are both novel and clinically significant, demonstrating an improved overall response rate and a favorable trend in progression-free survival outcomes with pirtobrutinib compared to ibrutinib across all populations, including treatment-naïve patients where covalent BTK inhibitors are a cornerstone of treatment," said Jennifer A. Woyach, M.D., professor, hematologist-oncologist, and Director of the Division of Hematology at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute. "BRUIN CLL-314 is the first randomized study to compare covalent and non-covalent BTK inhibitors and to directly compare any BTK inhibitors in the treatment-naïve setting, offering findings that are important for advancing the field and patient care. These efficacy results, along with pirtobrutinib's safety profile, offer strong evidence on the role of pirtobrutinib earlier in the treatment course for patients with CLL or SLL."
The BRUIN CLL-314 study enrolled 662 patients who were randomized to receive pirtobrutinib (n=331) or ibrutinib (n=331), with the ITT population consisting of 225 treatment-naïve and 437 relapsed/refractory patients. The efficacy results utilize a June 10, 2025, data cutoff date.
The study achieved its primary endpoint demonstrating that pirtobrutinib was statistically non-inferior to ibrutinib in independent review committee (IRC)-assessed ORR for the ITT population, and results numerically favored pirtobrutinib (
PFS, a key secondary endpoint, was not yet mature at this analysis but was trending in favor of pirtobrutinib compared to ibrutinib in the ITT (HR=0.569 [
The overall safety profile for patients treated with pirtobrutinib in BRUIN CLL-314 was similar to previously reported trials, and the most common treatment-emergent adverse events were similar between arms. Most adverse events (AE) of interest were lower with pirtobrutinib compared to ibrutinib, including atrial fibrillation/flutter (
"We are excited to share these compelling new findings for pirtobrutinib with the scientific community at ASH and in the Journal of Clinical Oncology," said Jacob Van Naarden, executive vice president and president, Lilly Oncology. "These data build on additional results from the BRUIN development program and the recent FDA approval for pirtobrutinib in the post-covalent BTK inhibitor setting to reinforce the medicine's potential to deliver meaningful benefit for people living with CLL or SLL across various disease settings."
As part of the Late-Breaking Abstract Session on Dec. 9, Lilly will also share results from the Phase 3 BRUIN CLL-313 study of pirtobrutinib versus chemoimmunotherapy in patients with treatment-naïve CLL/SLL without del(17p). These data were also selected to be highlighted as part of the ASH Annual Meeting press program session on Dec. 8.
Lilly is studying Jaypirca in CLL/SLL in multiple Phase 3 studies. Details on the trials can be found by visiting clinicaltrials.gov.
About BRUIN CLL-314
BRUIN CLL-314 is a Phase 3, randomized, open-label study of Jaypirca (pirtobrutinib) versus Imbruvica (ibrutinib) in patients with CLL/SLL who were either treatment-naïve, or who were previously treated and were BTK inhibitor-naïve. The trial planned to enroll 650 patients who were randomized 1:1 to receive pirtobrutinib (200 mg orally, once daily) or ibrutinib (420 mg orally, once daily). The primary endpoint is ORR as assessed by blinded IRC. Secondary endpoints include investigator and IRC-assessed PFS, duration of response (DoR) and event-free survival (EFS), and time to next treatment (TTNT), OS, 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/Small Lymphocytic Lymphoma
Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are forms of slow-growing non-Hodgkin lymphoma that develop from white blood cells known as lymphocytes.4 CLL is one of the most common types of leukemia in adults.4 In the U.S., CLL accounts for about one-quarter of the new cases of leukemia and there will be approximately 23,690 new cases of CLL diagnosed this year.4,5 SLL is identical to CLL from a pathologic and immunophenotypic standpoint, with the main difference between them being the location of the cancer cells.4 In CLL, the cancer cells are present in the blood, and in SLL, the cancer cells are found in the lymph nodes.4
INDICATIONS FOR JAYPIRCA (pirtobrutinib)
Jaypirca is indicated for the treatment of
- Adult patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) who have previously been treated with a covalent BTK inhibitor.
- Adult patients with relapsed or refractory (R/R) mantle cell lymphoma (MCL) after at least two lines of systemic therapy, including a BTK inhibitor. This indication is approved under accelerated approval based on response rate. Continued approval for this indication may be contingent upon verification and description of clinical trial 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. Across clinical trials, Grade ≥3 infections occurred (
Hemorrhage: Fatal and serious hemorrhage has occurred with Jaypirca. Across clinical trials, major hemorrhage (Grade ≥3 bleeding or any central nervous system bleeding) occurred (
Cytopenias: Jaypirca can cause cytopenias, including neutropenia, thrombocytopenia, and anemia. Across clinical trials, Grade 3 or 4 cytopenias, including decreased neutrophils (
Cardiac Arrhythmias: Cardiac arrhythmias occurred in patients taking Jaypirca. Across clinical trials, atrial fibrillation or flutter were reported in
Second Primary Malignancies: Across clinical trials, 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. If DILI is confirmed, discontinue Jaypirca.
Embryo-Fetal Toxicity: Jaypirca can cause fetal harm. 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 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 Due to ARs: Dose reductions in
Most common ARs (≥
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma from Single-Arm and Randomized Controlled Clinical Trials
Serious ARs occurred in 47
Dose Modifications and Discontinuations Due to ARs: Dose reductions in 3.6
Most common ARs and Select Laboratory Abnormalities (≥
Drug Interactions
Strong CYP3A Inhibitors: Concomitant use increased pirtobrutinib systemic exposure, which may increase risk of Jaypirca ARs. Avoid using strong CYP3A inhibitors with Jaypirca. If concomitant use is unavoidable, reduce Jaypirca dose according to approved labeling.
Strong or Moderate CYP3A Inducers: Concomitant use decreased pirtobrutinib systemic exposure, which may reduce Jaypirca efficacy. Avoid using Jaypirca with strong or moderate CYP3A inducers. If concomitant use with moderate CYP3A inducers is unavoidable, increase Jaypirca dose according to approved labeling.
Sensitive CYP2C8, CYP2C19, CYP3A, P-gp, or BCRP Substrates: Use with Jaypirca increased their plasma concentrations, which may increase risk of ARs related to these substrates for drugs sensitive to minimal concentration changes. Follow recommendations for these sensitive substrates in their approved labeling.
Use in Specific 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. Presence of pirtobrutinib in human milk is unknown. Advise women to use effective contraception and to not 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: Because severe renal impairment increases pirtobrutinib exposure, reduce Jaypirca dose in these patients according to approved labeling.
PT HCP ISI MCL_CLL Q42025
Please see Prescribing Information and Patient Information for Jaypirca.
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 nearly 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. To learn more, visit Lilly.com and Lilly.com/news, or follow us on Facebook, Instagram, and LinkedIn. P-LLY
© Lilly
Trademarks and Trade Names
All trademarks or trade names referred to in this press release are the property of the company, or, to the extent trademarks or trade names belonging to other companies are referenced in this press release, the property of their respective owners. Solely for convenience, the trademarks and trade names in this press release are referred to without the ® and ™ symbols, but such references should not be construed as any indicator that the company or, to the extent applicable, their respective owners will not assert, to the fullest extent under applicable law, the company's or their rights thereto. We do not intend the use or display of other companies' trademarks and trade names to imply a relationship with, or endorsement or sponsorship of us by, any other companies.
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 as a treatment for adults with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL) who have been previously treated with a covalent 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 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, or that Jaypirca will receive additional regulatory approvals. 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.
Endnotes & References
- 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 Feb 18, 2023]. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470433/
- NCI SEER Program [NIH]. Cancer Stat Facts: Leukemia—Chronic Lymphocytic Leukemia (CLL). Accessed on September 3, 2025. https://seer.cancer.gov/statfacts/html/clyl.html
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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SOURCE Eli Lilly and Company
