Abstract
Background: Phosphatidylinositol 3-kinase (PI3K) is an essential target in lymphoid tumors therapy.
Copanlisib is a novel class of medication that targets PI3K and used for the treatment of relapsing or
refractory B-cell lymphomas.
Case Presentation: A 42-year-old woman presents to our hospital for worsening abdominal pain.
Examination pertinent for axillary lymphadenopathy, and abdominal ascites. CT chest, abdomen and pelvis
reported multiple lung nodules, pleural effusions, extensive retroperitoneal lymphadenopathy, and
peritoneal carcinomatosis. Lymph node and bone marrow biopsies confirmed B-cell follicular lymphoma
and fluorescent in situ hybridization (FISH) testing was positive for translocation t(14:18). Her disease was
refractory to multiple chemotherapy regimens. Thus, initiated copanlisib therapy with a remarkable
response, but the patient developed a diffuse maculopapular rash and skin biopsy-proven to be drug rash.
Therefore, copanlisib was discontinued.
Conclusion: Here, we report a case of a middle-aged woman who developed a rash after the fifth cycle of
copanlisib therapy. This case report will create awareness of evolving possible side effects in this novel
chemotherapeutic agent.