The Phosphoinositide 3-kinase (PI3K) pathway is often altered in primary PCa through genetic alterations in components such as PTEN, PIK3CA, and AKT1. PTEN is an important negative regulator of the pathway and at least one copy is deleted in 19–29% of primary PCa (Figure 1) [67]. This evidence concerns the gene AKT1 and posterior cortical atrophy.