Beyond the Green: One Golfer’s Journey with Blood Cancer

Terry Evans is in a paid partnership with Lilly and has been compensated for his time.

Like many parents back in the 1990s, Terry Evans of Huntington Beach, Calif., was wrapped up in his job and shuttling his kids back and forth to their various activities and social events. “Golf didn’t fit into our lifestyle at the time,” said Evans, but as his children grew up and his family responsibilities lessened, Evans was invited by co-workers to play nighttime nines at nearby Hartwell Golf Course in Long Beach, a par-3 course that Tiger Woods frequented as a youngster.

“Although I played multiple sports growing up, golf was the most challenging of all, and I just got hooked,” said Evans, now 77 years of age. “I could hardly wait every week for golf night, and then I joined a golf league to improve my game. After two years, I helped run it.”

His life suddenly changed in June 2000. A routine blood test identified abnormalities, leading to follow-up tests. A hematologist diagnosed Evans with early-stage chronic lymphocytic leukemia (CLL), a slow-growing non-Hodgkin lymphoma that develops from white blood cells known as lymphocytes.(1,2) “I’d never heard of it,” said Evans. “I felt fine – no symptoms other than this anomaly in my blood. It was a complete shock. My immediate reaction was, ‘Let's fix this,’ but my doctor said, ‘We don't do anything right now,’ and instead advised that they monitor the disease.”

Following a CLL diagnosis, many people living with this blood cancer will begin with “active surveillance” or a watch-and-wait period, which means a doctor will monitor a patient’s condition, but they won’t begin treatment unless their symptoms begin to change.(3) In 2005, still monitoring his CLL, Evans opted to retire from his IT manager job and spend more time with his wife and family while continuing to play golf. “Looking back, CLL faded to the back of my mind, and I realize I could have spent more time learning about my diagnosis. At the time, I relied on my faith that everything was going to be okay with each passing year that symptoms didn’t arise,” he said. “I later realized that I hadn't done the homework I should have.”

By late 2007, Evans began experiencing fatigue, night sweats, and weight loss. These signs of disease progression led him to start on a treatment.(3) Soon after, Evans’ wife – a nurse – wanted to get another opinion on his treatment options and was able to get his bloodwork to a CLL specialist, who detected an extremely low hemoglobin level. By the following week, Evans was hospitalized. “This was a turning point for me, I realized the importance of seeing a specialist who has experience treating this disease,” said Evans.

Since his hospital visit in 2007, Evans vowed to put in the work to educate himself on his condition, including understanding current treatment options, and research that was being conducted to develop new therapies for people with CLL. Thankfully, treatments have advanced since Evans’ initial diagnosis, providing new options. He received multiple treatments over the years, which he responded to but ultimately had to move on from after eventual disease progression.

Despite progress in treating CLL, including targeted therapy breakthroughs and options such as Bruton tyrosine kinase (BTK) inhibitors, B-cell lymphoma 2 (BCL-2) inhibitors, monoclonal antibodies and others, patients like Evans often experience peaks and valleys that can lead to eventual relapse or progression, revealing a critical need for additional options.(4)

By 2023, after trying several other treatments including BTK and BCL-2 inhibitors, Evans’ doctor informed him that his CLL had progressed, and it was time to consider another treatment option. One of those options was Jaypirca® (pirtobrutinib). Jaypirca (100 mg & 50 mg tablets) is a prescription medicine used to treat adults with CLL or small lymphocytic lymphoma (SLL) that has come back or did not respond to previous treatment and who have already been treated with a BTK inhibitor for their cancer. It is not known if Jaypirca is safe and effective in children.(5)

Cancer drugs called BTK inhibitors can stop, or inhibit, cancer cells from surviving and multiplying, which can slow the spread of CLL.(6) Jaypirca works in a different way* to help block BTK, which is one of the proteins that cause CLL cancer cells to grow.

*Jaypirca, a noncovalent BTK inhibitor, works differently than other BTK inhibitors you may have taken before. For CLL, it was developed to work after you have taken a covalent BTK inhibitor.(7,8)

SELECT SAFETY INFORMATION:

Warnings - Jaypirca may cause serious side effects, including infections. Infections can happen during treatment with Jaypirca. These infections can be serious and may lead to death. Your doctor may prescribe vaccines and certain medicines if you have an increased risk of getting infections. Tell your doctor right away if you have fever, chills, weakness, flu-like symptoms, or any other signs of infection during treatment with Jaypirca.

“I’m grateful that CLL hasn’t kept me from what matters most to me,” said Evans, who plays golf, still travels on golf trips with his wife and continues to run his golf league with his son as his partner. “I’m thankful that I haven’t had to step away from the golf course.”

In a clinical trial that measured the number of people who responded to treatment and how long the response lasted, 72% of adults with CLL (78 out of 108) saw their cancer shrink and stop spreading while taking Jaypirca, with responses lasting a median (median is the middle number in range of numbers) of 12.2 months.(7)

Jaypirca was studied in a clinical trial that evaluated 108 adults with CLL who had already received at least two treatments including a BTK inhibitor and BCL-2 inhibitor to see how many responded to treatment and how long the response lasted.(7)

Over the past 25 years, Evans also found support in the advocacy community and now volunteers with CLL Society, a physician-founded, patient-centric nonprofit organization with a mission to address the unmet needs of the CLL and SLL community through patient education, advocacy, support, and research. Evans helps lead the Southern California chapter, facilitating over 40 support groups throughout the U.S. and one-on-one meetings that educate patients and caregivers across North America. “Up until my first treatment, I went seven years without knowing another CLL patient,” he said. “That was a very lonely time. I felt a strong desire to give back and help others facing this disease understand that there’s a community standing by them that knows what they’re going through.”

There are roughly 100,000 new cases of CLL globally each year.(9) In the U.S. alone, approximately 23,690 new cases will be diagnosed this year.(10) Lilly is working with advocacy organizations and directly with the blood cancer community to raise awareness of unmet needs in CLL and is committed to answering critical questions facing the treatment landscape that will help advance the medicines for people living with blood cancer. To learn more about Jaypirca, visit https://jaypirca.lilly.com/.

INDICATION AND SAFETY SUMMARY

Jaypirca® (JAY-PIHR-KAA) is a prescription medicine used to treat adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) that has come back or did not respond to previous treatment and who have already been treated with a BTK inhibitor for cancer.

It is not known if Jaypirca is safe and effective in children.

Warnings - Jaypirca may cause serious side effects, including:

Infections. Infections can happen during treatment with Jaypirca. These infections can be serious and may lead to death. Your doctor may prescribe vaccines and certain medicines if you have an increased risk of getting infections. Tell your doctor right away if you have fever, chills, weakness, flu-like symptoms, or any other signs of infection during treatment with Jaypirca.

Bleeding problems (hemorrhage). Bleeding problems can happen during treatment with Jaypirca. They can be serious and may lead to death. Your risk of severe bleeding may increase if you are also taking a blood thinner medicine. Tell your doctor if you have any signs or symptoms of bleeding, including:

• blood in your stools or black stools (looks like tar)
• pink or brown urine
• unexpected bleeding, or bleeding that is severe or you cannot control
• vomit blood or vomit blood that looks like coffee grinds
• cough up blood or blood clots
• increased bruising
• dizziness
• weakness
• confusion
• changes in your speech
• headache that lasts a long time

Decrease in blood cell counts. Decrease in white blood cells, platelets, and red blood cells are common with Jaypirca, but can also be severe. This may increase your risk of infection, bleeding, and anemia. Your doctor should do blood tests regularly during treatment to monitor your counts.

Heart rhythm problems. Heart rhythm problems including atrial fibrillation and atrial flutter have happened in people treated with Jaypirca. Your risk for heart rhythm problems may be increased if you have high blood pressure or have had heart rhythm problems in the past. Tell your doctor if you have any of the following symptoms:

• fast or irregular heartbeat (palpitations)
• dizziness
• fainting
• chest discomfort
• shortness of breath

Second primary cancers. New cancers have happened during treatment with Jaypirca, including cancers of the skin or other organs. Your doctor will check you for other cancers during treatment. Use sun protection when you are outside in sunlight.

Liver Problems. Liver problems, which may be severe or life-threatening, or lead to death, can happen in people treated with Jaypirca. Your doctor will do blood tests to check your liver before and during treatment with Jaypirca. Tell your doctor or get medical help right away if you have any signs of liver problems, including stomach pain or discomfort, dark-colored urine, or yellow skin and eyes.

Your doctor may decrease your dose, temporarily stop, or permanently stop treatment with Jaypirca if you develop severe side effects.

Common side effects

• decreased white blood cell count
• decreased red blood cell count
• tiredness
• decreased platelet count
• decreased calcium

These are not all the possible side effects with Jaypirca. Call your doctor for medical advice about side effects. You may report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before using
Before taking Jaypirca, tell your doctor about all your medical conditions, including if you:

• have an infection or have been advised that you are at increased risk of infection
• have had recent surgery or plan to have surgery. Your doctor may stop Jaypirca for a planned medical, surgical, or dental procedure
• have bleeding problems and/or are taking blood thinner medicine
• have or have had heart rhythm problems
• have high blood pressure
• have a history of other cancers, including skin cancer
• have kidney problems
• have liver problems
• are pregnant or plan to become pregnant. Jaypirca can harm your unborn baby. If you are able to become pregnant, your doctor will do a pregnancy test before starting treatment:
  • Females who are able to become pregnant should use effective birth control (contraception) during treatment and for at least 1 week after the last dose of Jaypirca. Tell your doctor right away if you become pregnant or think you are pregnant during treatment
• are breastfeeding or plan to breastfeed. It is not known if Jaypirca passes into breast milk. Do not breastfeed during treatment and for at least 1 week after your final dose

Also tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking Jaypirca with certain other medicines may affect how Jaypirca or the other medicines work and can cause side effects.

How to take

• Take Jaypirca exactly as your doctor tells you
• Do not change your dose or stop taking Jaypirca unless your healthcare provider tells you to do so
• Take Jaypirca 1 time each day at about the same time each day
• Take Jaypirca with or without food
• Swallow Jaypirca whole with water. Do not cut, crush, or chew the tablets
• If you miss a dose of Jaypirca, take it as soon as you remember on the same day. If you miss taking a dose by more than 12 hours from the time you usually take Jaypirca, skip the missed dose. Take the next dose on the next day at your usual time

Learn more

Jaypirca is a prescription medicine. For more information, call 1-800-545-5979 or go to www.jaypirca.lilly.com. This summary provides basic information about Jaypirca but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your doctor. Be sure to talk to your doctor or other healthcare provider about Jaypirca and how to take it. Your doctor is the best person to help you decide if Jaypirca is right for you.

PT CON BS CLL DEC2025

Jaypirca® is a registered trademark owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

References:

1. Mukkamalla, S. K. R., Taneja, A., Malipeddi, D., Patel, H., & Alomari, M. (2023, February 18). Chronic lymphocytic leukemia. PubMed. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470433/
2. NCI Dictionary of Cancer Terms. (2025). Cancer.gov; National Cancer Institute. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/nhl
3. Chronic Lymphocytic Leukemia Treatment. (2024, October 15). Cancer.gov; National Cancer Institute. https://www.cancer.gov/types/leukemia/patient/cll-treatment-pdq
4. Gu, D., Tang, H., Wu, J., Li, J., & Miao, Y. (2021). Targeting Bruton tyrosine kinase using non-covalent inhibitors in B cell malignancies. Journal of Hematology & Oncology, 14(1), 40. https://doi.org/10.1186/s13045-021-01049-7
5. Jaypirca. Patient Information. Lilly USA, LLC.
6. Hendriks, R. W., Yuvaraj, S., & Kil, L. P. (2014). Targeting Bruton's tyrosine kinase in B cell malignancies. Nature reviews. Cancer, 14(4), 219–232. https://doi.org/10.1038/nrc3702
7. Jaypirca. Prescribing Information. Lilly USA, LLC.
8. Wen T, Wang, J, Shi Y, et al. Inhibitors targeting Bruton’s tyrosine kinase in cancers: Drug development advances. Leukemia. 2021;35(2), 312–332. doi:10.1038/s41375-020-01072-6
9. Fedele, P. L., & Opat, S. (2024a). Chronic lymphocytic leukemia: Time to care for the survivors. Journal of Clinical Oncology, 42(17), 2005–2011. doi:10.1200/jco.23.02738
10. Chronic Lymphocytic Leukemia - Cancer Stat Facts. (2025). SEER.Cancer.Gov; National Cancer Institute. https://seer.cancer.gov/statfacts/html/clyl.html

PP-PT-US-1343 12/2025 ©Lilly USA, LLC 2025. All rights reserved.