The authors also found that primary tumours with PBRM1-SETD2 and PBRM1-PI3K driver mutations and high tumour heterogeneity were associated with attenuated progression.33 These results suggest that certain genetic alterations are capable of increasing metastatic competence but that these mutations are not exclusive to metastasis as they are already selected for in primary tumours. This evidence concerns the gene PBRM1 and neoplasm.