{
  "abstract": "During the last decade, many new treatment options for chronic lymphatic leukemia (CLL) have become available, one of them being covalent-binding Bruton's tyrosine kinase inhibitors (cBTK inhibitors [cBTKis]). There are currently three cBTKis approved for treatment of CLL/SLL: acalabrutinib, ibrutinib, and zanubrutinib. In relapsed and heavily pretreated patients, BTK inhibitors achieve a median PFS of 4 years, and in frontline, around 80% of CLL patients are still in remission and alive after 4 years of treatment with BTK inhibitors. Despite their efficacy, 40% of patients have to discontinue BTK inhibitors because of side effects or treatment resistance. We present the efficacy of the novel noncovalent BTKi in a patient with CLL who developed covalent BTKi-resistant disease with CNS localization. Pirtobrutinib appears to be effective in patients with ibrutinib resistance, even with CNS localization. Clinical responses may take several months to become evident.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Hematology Radboud UMC Nijmegen the Netherlands.",
    "Department of Hematology Amsterdam UMC Amsterdam the Netherlands amc.nl.",
    "Department of Hematology Rijnstate Ziekenhuis Arnhem the Netherlands."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "M E Roerink",
      "orcid": "0009-0009-8708-2849"
    },
    {
      "affs": [
        1
      ],
      "name": "A P Kater",
      "orcid": "0000-0003-3190-1891"
    },
    {
      "affs": [
        1
      ],
      "name": "S H Tonino"
    },
    {
      "affs": [
        2
      ],
      "name": "E van der Spek"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9xqaadkssvpkf.bib",
  "cited_by": 0,
  "doi": "10.1155/crh/1249723",
  "fulltext_url": "https://europepmc.org/articles/PMC13681179",
  "id": "9xqaadkssvpkf",
  "issns": [
    "2090-6560",
    "2090-6579"
  ],
  "landing_url": "https://europepmc.org/article/MED/42903336",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2716|Chronic Lymphocytic Leukemia Research"
    ]
  ],
  "openalex": "W7223030837",
  "pdf_url": "https://europepmc.org/articles/PMC13681179?pdf=render",
  "pmcid": "PMC13681179",
  "pmid": "42903336",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9xqaadkssvpkf.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:53Z",
      "native_id": "MED:42903336",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42903336"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Chronic Lymphocytic Leukemia Research",
      "subfield": "human-genetics"
    }
  ],
  "title": "Pirtobrutinib for the Treatment of Therapy-Resistant Chronic Lymphatic Leukemia With CNS Localization.",
  "title_text": "Pirtobrutinib for the Treatment of Therapy-Resistant Chronic Lymphatic Leukemia With CNS Localization.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:53Z",
  "url": "https://research.draconitic.com/paper/9xqaadkssvpkf",
  "venue": "Case reports in hematology",
  "versions": []
}