In EBV-positive gastric cancer, PIK3CA mutations are not restricted to hotspots (helical or kinase domains) but rather are spread across many gene segments.10 Clinical trials of various PIK3CA/AKT/mTOR inhibitors (e.g. everolimus, BEZ235) showed disappointing results as single agents in gastric cancer, and dual pathway inhibition is now being explored.55, 56, 57, 58, 59, 60 Unique cancer prevention strategies are also being explored for PIK3CA-mutated cancers. This evidence concerns the gene PIK3CA and cancer.