Analysis of whether the disease will relapse rapidly after discontinuation of Pitobrutinib/Pitobrutinib (Zepali)

Pitobrutinib/Pirtobrutinib (pirtobrutinib), as a BTK inhibitor, has clear efficacy in relapsed or refractory chronic lymphocytic leukemia (CLL) and other B cell lymphomas. Whether the disease will relapse rapidly after discontinuation of medication needs to be comprehensively considered based on the patient's disease status, duration of medication, and pathological characteristics. Clinical experience shows that BTK inhibitor drugs inhibit the proliferation of malignant B cells by continuously blocking the B cell receptor signaling pathway. Once the drug is stopped, the signaling pathway is reactivated and the tumor cells may resume proliferation activity. Therefore, there is a certain risk of recurrence, but the specific speed varies from person to person.

Among patients who have long-term use of pitubrutinib, if they achieve significant remission after treatment, some patients can still maintain a stable state in the short term after stopping the drug. However, most clinical observations show that after stopping the drug for more than a few weeks to a few months, hematological indicators and lymph node size may gradually rebound. Especially in patients with a longer disease course or a larger disease burden, the relapse rate may be faster. Therefore, stopping the drug does not mean stopping the treatment completely safely, but requires close follow-up and monitoring of blood indicators.

In addition, the speed of disease recurrence after drug withdrawal is also related to whether the patient has a drug-resistant clone or concurrent genetic mutations. Some patients may have developed drug-resistant clones during long-term use of BTK inhibitors, and these clones may rapidly expand after drug withdrawal, accelerating disease progression. Clinical recommendations are that if it is necessary to temporarily stop the drug, a detailed monitoring plan should be developed with the attending doctor, including routine blood tests, lymph node imaging examinations and symptom assessment, so as to detect changes in the condition in a timely manner and restart treatment or adjust the plan as soon as possible if necessary.

In general, there is a certain risk of recurrence after discontinuation of pitubrutinib, and the rate of recurrence varies between individuals. Patients must fully understand the potential risks before discontinuing medication and decide the time and conditions for discontinuation under the guidance of a doctor. Through standardized follow-up and monitoring, even if disease progression occurs, early measures can be taken to reduce the impact on the patient's overall prognosis. Therefore, the discontinuation operation must be cautious and avoid blindly stopping the medication on your own to ensure the safety of treatment and the continuity of disease control.

Reference materials:https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/216059s002lbl.pdf