The comparative analysis of the mutational alterations in primary and metastatic tumors compared to the primary tumors is as follows; PI3K (40% vs. 17%), DNA repair (27% vs 10%), Epigenetic regulators (27% vs. 17%), Cell cycle (24% vs. 9%), WNT/CTNNB1 (19% vs. 6%) RAS/RAF/MAPK (8% vs. 4%), and Splicing (7% vs. 2%) (Figure 1) [61]. The gene discussed is PIK3CA; the disease is metastatic neoplasm.