PIK3CA and neoplasm: Alterations of the PI3K pathway genes were reported to be associated with poor response to HER2-targeted therapy in patients with HER2+ tumors [30], and this finding concurs with the present finding indicating the poor outcome of patients having a tumor with HER2 IHC 2+/3+ and nonamplified HER2. These findings support the statement that FISH analysis should be the primary HER2 testing for patients who are candidates for HER2-targeted therapies [9].