Copanlisib Chinese PK Study

This study will be conducted primarily to determine the pharmacokinetics of copanlisib in Chinese patients with relapsed iNHL.

The primary objective of the study is to determine the pharmacokinetics of copanlisib administered on Day1, 8, and 15 of a 28-days cycle (3 weeks-on/1 week off dosing regimen) as a 1 hour intravenous infusion to Chinese patients with relapsed iNHL.

The secondary objectives include the evaluation of safety, tolerability, and tumor response of Chinese patients treated with Copanlisib.

Determine the pharmacokinetics of M-1 metabolite.


Eligibility Criteria:
Inclusion Criteria:

* Ability to understand and to sign an informed consent form. The informed consent must be signed before any study specific tests or procedures are done
* Chinese, age ≥ 18 years
* Patients with histologically confirmed indolent NHL (excluding chronic lymphocytic leukemia) that have relapsed and who are without past or current central nervous system involvement.
* Patients must have at least 1 measurable lesion according to the Lugano Classification.

  * Patients affected by LPL/WM must have also measurable disease, defined as presence of IgM paraprotein with a minimum IgM level of equal to or greater than 2 times the upper limit of normal (ULN) OR over 10% of lymphoplasmacytic cells in bone marrow.
  * Patients with splenic MZL with splenomegaly but no measurable lesion will be considered eligible.
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1
* Life expectancy of at least 12 weeks
* Left ventricular ejection fraction (LVEF) ≥ 50%
* Prothrombin time (PT) or international normalized ratio (INR) and activated partial thromboplastin time (aPTT) \< 1.5 x the upper limit of normal (ULN)
* Adequate bone marrow, liver and renal function
* Women of childbearing potential must have a pregnancy test performed a maximum of 7 days before start of treatment, and a negative result must be documented before start of treatment
* Women of childbearing potential and men must agree to use highly effective contraception from signing of the informed consent form until at least 1 month after the last study drug administration. The investigator or a designated associate is requested to advise the patient how to achieve highly effective birth control (failure rate of less than 1% per year), e.g. hormonal contraception associated with inhibition of ovulation, intrauterine device (IUD), intrauterine hormone-releasing system (IUS), bilateral tubal occlusion, vasectomized partner and sexual abstinence

Exclusion Criteria:

Medical and surgical history:

* Uncontrolled hypertension (Blood pressure ≥ 150/90 mmHg despite optimal medical management)
* Proteinuria of CTCAE grade 3 or higher (\> 3.5 g/24 h, measured by urine protein: creatinine ratio on a random urine sample)
* Known bleeding diathesis. Any hemorrhage or bleeding event ≥ Grade 3 within 28 days of start of study medication. (NCI-CTCAE Version 4.03)
* Uncontrolled diabetes with HbA1c ≥ 8.5%
* Ongoing cytomegalovirus (CMV) infection as confirmed by positive polymerase chain reaction (PCR) for CMV

Excluded previous therapies and medications:

* Prior treatment with PI3K inhibitors
* Anticancer chemotherapy or immunotherapy during the study or within 28 days of first study treatment.
* Patients must have recovered from the toxic effects (Grade \<2) of the previous anti-cancer chemotherapy or immunotherapy (with the exception of alopecia)
* Biological response modifiers, such as Granulocyte colony stimulating factor (GCSF) within 14 days of first study treatment. G-CSF and other hematopoietic growth factors may be used in the management of acute toxicity such as febrile neutropenia when clinically indicated or at the discretion of the principal investigator; however they may not be substituted for a required dose reduction
* Use of strong inhibitors of CYP3A4 is prohibited from Day -14 and for the duration of the study
* Use of St John's Wort or strong inducers of CYP3A4 is prohibited from Day -14 and for the duration of the study