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Combination of copanlisib, a **pan-class I PI3K inhibitor** predominantly targeting PI3K-α and PI3K-δ, and rituximab, a monoclonal antibody against CD20 on B cells. Used primarily for **relapsed indolent non-Hodgkin lymphoma**, this regimen was shown in the CHRONOS-3 phase III trial to significantly prolong progression-free survival and increase response rates compared to rituximab with placebo, with improved outcomes in follicular lymphoma, marginal zone lymphoma, and small lymphocytic lymphoma[1][4]. Copanlisib disrupts B cell receptor and PI3K pathway survival signaling, countering resistance mechanisms in B-cell malignancies, while rituximab induces antibody-dependent cellular cytotoxicity and complement-mediated lysis[1][2][8]. The combination is delivered intravenously; common adverse events include transient hyperglycemia and hypertension[1].
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