As an outcome, PIK3CA expression has no impact on survival.[28] Dysregulation of this pathway is strongly associated with OCCC pathogenesis and chemoresistance.[42] PI3K/Akt activation promotes the active excretion of drug molecules from target cells,[43] a process reinforced by PIK3CA mutation, which enhances PIK3 activity.[44] The mutation is seen as early as endometriosis, which is considered the predecessor of OCCC.[27] Despite this association, however, the clinical importance of this mutation is still debatable. The gene discussed is PIK3CA; the disease is endometriosis.