Copanlisib is an intravenously administered PI3K inhibitor typically used to treat relapsed and refractory follicular lymphoma, but the addition of copanlisib to trastuzumab and pertuzumab in HER2 + BC therapy could increase the duration of response as compared to the standard treatment, overcoming the resistance due to the hyperactivation of PI3K signaling downstream of HER2. This evidence concerns the gene PIK3CA and breast cancer.