It has been reported that bilirubin plays a role in the defense against cancer by interfering with pro-cancerogenic signaling pathways.[58] Interestingly, our previous serum metabolomics study of the same Dicer-Pten DKO mouse model also identified bilirubin as a marker for detecting early-stage HGSC, highlighting the potential for MSI to complement more traditional biomarker discovery studies. This evidence concerns the gene PTEN and cancer.