New Reference: Pirtobrutinib vs. Ibrutinib in CLL

Pirtobrutinib was shown to be non-inferior to ibrutinib in terms of overall response rate and had a more favorable safety profile, with lower rates of adverse cardiac events. The study indicated that pirtobrutinib could be a preferable option, especially for treatment-naive patients, as it demonstrated better progression-free survival rates.

  • Study

    Randomized, open-label, phase III study [BRUIN-CLL-314] Treatment-Naive(TN) or relapsed/refractory CLL/SLL
    Pirtobrutinib (n=331) vs Ibrutinib (n=331)



  • Efficacy

    ORR: 87% vs 78.5% (pirtobrutinib vs. ibrutinib) (p<0.001)
    18-mo PFS: 86.9% vs 82.3% (HR 0.57 [0.39-0.83])
    18-mo PFS in TN: 95.3% vs 87.6% (HR 0.24 [0.10-0.59])



  • Safety

    Grade >=3 AEs: atrial fibrillation (0.9% vs 4%), hypertension (3.3% vs 4.9%), neutropenia (25.3% vs 17.5%), thrombocytopenia (11.8% vs 17.5%)
    Serious AEs: bleeding (3.3% vs 2.8%)
    Treatment discontinuations due to AE (9.4% vs 10.8%)


  • J Clin Oncol. Published online December 7, 2025

    Woyach JA, Qiu L, Grosicki S Pirtobrutinib Versus Ibrutinib in Treatment-Naive and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

    http://doi.org/10.1200/JCO-25-02477

    Reviewed by Ulas D. Bayraktar, MD on Jan 21, 2026

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