Several recent clinical reports provide compelling evidence that only a minority of colorectal tumours with K-Ras, B-Raf or PIK3CA mutations respond to novel EGFR-targeted monoclonal antibody therapies including cetuximab and panitumimab (Lièvre et al, 2006; Nicolantonio et al, 2008; Allegra et al, 2009; Sartore-Bianchi et al, 2009). This evidence concerns the gene PIK3CA and colorectal neoplasm.