Recently, PIK3CA mutations have reached level 1 evidence to predict the benefit of alpelisib, an alpha-specific inhibitor of PI3K, in combination with fulvestrant in patients with advanced hormone receptor-positive/HER2-negative breast cancer previously treated with endocrine therapy, highlighting the usefulness of determining these affectations in oncological practice [16,17,18,19]. The gene discussed is PIK3CA; the disease is breast cancer.