PIK3CA and breast carcinoma: However, results from the secondary biomarker analysis of BOLERO‐2 study suggested that everolimus benefit was independent of PIK3CA gene status in HR+ HER2‐ breast cancer,28, 29 in line with the results from the phase II SHIVA trial, showing that patients harboring PI3K/ATK/mTOR pathway alterations did not benefit from matched everolimus treatment compared with treatment at physician's choice (HR 0.79, 95% CI 0.51‐1.24, P = .30).4 Taken together, the benefit of everolimus in refractory breast cancer patients harboring activation alterations in PI3K/ATK/mTOR pathway remains unclear.