Copanlisib and Venetoclax for the Treatment of Relapsed or Refractory Mantle Cell Lymphoma

Inclusion Criteria

• •Documented informed consent of the participant and/or legally authorized representative
• •* Assent, when appropriate, will be obtained per institutional guidelines
• •Agreement to allow the use of archival tissue from diagnostic tumor biopsies
• •* If unavailable, exceptions may be granted with study principal investigator (PI) approval
• •Age: \>= 18 years
• •Eastern Cooperative Oncology Group (ECOG) =\< 2
• •Life expectancy \>= 3 months (per physician assessment)
• •Ability to take oral medication
• •Pathologically confirmed MCL, with documentation of monoclonal B cells showing one of the following:
• •* Overexpression of cyclin D1 in association with other relevant markers (e.g., CD19, CD20, PAX5, CD5), OR
• •* Chromosomal translocation t(11;14)(q13; q32), as assessed by cytogenetics, fluorescent in situ hybridization (FISH), or polymerase chain reaction (PCR)
• •Documented failure to achieve at least partial response (PR) with, or documented disease progression after the most recent treatment regimen
• •At least 1 prior treatment regimen for MCL which either included chemo-immunotherapy or a targeted agent (i.e., ibrutinib) administered for at least 2 cycles
• •Have radiologically measurable lymphadenopathy or extranodal lesion, (defined as \>= 1 lesion that measures \>= 2.0 cm in the longest diameter), or splenomegaly, or bone marrow involvement with or without malignant lymphocytosis
• •Absolute neutrophil count (ANC) \>= 1,000/mm\^3 without bone marrow involvement or ANC \>= 500/mm\^3 with bone marrow involvement (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Platelets \>= 50,000/mm\^3 without bone marrow involvement or platelets \>= 30,000/mm\^3 with bone marrow involvement (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •* NOTE: Platelet transfusions are not permitted within 7 days of platelet assessment
• •Total bilirubin =\< 2 x upper limit of normal (ULN) (unless has Gilbert's disease or documented liver/biliary involvement by the lymphoma) (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Aspartate aminotransferase (AST) =\< 2.5 x ULN (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Alanine aminotransferase (ALT) =\< 2.5 x ULN (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Creatinine clearance of \>= 30 mL/min per 24 hour urine test or the Cockcroft-Gault formula (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •If not receiving anticoagulants: International normalized ratio (INR) OR prothrombin time (PT) =\< 1.5 x ULN (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •If on anticoagulant therapy: PT must be within therapeutic range of intended use of anticoagulants (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •If not receiving anticoagulants: Activated partial thromboplastin time (aPTT) =\< 1.5 x ULN (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •If on anticoagulant therapy: aPTT must be within therapeutic range of intended use of anticoagulants (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Left ventricular ejection fraction (LVEF) \>= 45% (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •* Note: To be performed within 28 days prior to day 1 of protocol therapy
• •Seronegative for human immunodeficiency virus (HIV) antigen (Ag)/antibody (Ab) combo, hepatitis C virus (HCV), active hepatitis B virus (HBV) (surface antigen negative) (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •* If positive, hepatitis C ribonucleic acid (RNA) quantitation must be performed
• •Meets other institutional and federal requirements for infectious disease titer requirements (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •* Note Infectious disease testing to be performed within 28 days prior to day 1 of protocol therapy
• •Lipase =\< 1.5 ULN (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Glycosylated hemoglobin (HbA1c) =\< 8.5% (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •Women of childbearing potential (WOCBP): negative urine or serum pregnancy test (to be performed within 30 days prior to day 1 of protocol therapy unless otherwise stated)
• •* If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
• •Agreement by females and males of childbearing potential to use an effective method of birth control or abstain from heterosexual activity for the course of the study through at least 30 days after the last dose of protocol therapy
• •* Childbearing potential defined as not being surgically sterilized (men and women) or have not been free from menses for \> 1 year (women only) without an alternative medical cause.