We previously reported 4 PIK3CA mutations in 38 head and neck cancer samples, 3 of which were identified in 6 pharyngeal cancer samples. To determine the mutation frequency of PIK3CA in pharyngeal cancer, we studied 24 additional cases of pharyngeal squamous cell carcinoma in this study. Using both direct genomic DNA sequencing and novel mutant-enriched sequencing methods developed specifically for the 3 hot-spot mutations (H1047R, E545K and E452K) of PIK3CA, we detected 5 mutations of PIK3CA in the 24 pharyngeal cancers (20.8%). Three of the 5 mutations had been missed by the conventional sequencing method and were subsequently detected by novel mutant-enriched sequencing methods. We showed that the mutant-enriched sequencing method for the H1047R hot-spot mutation can identify the mutation in a mixed population of mutant and wild-type DNA sequences at 1:360 ratios. These novel mutant-enriched sequencing methods allow the detection of the PIK3CA hot-spot mutations in clinical specimens which often contain limited tumor tissues (i.e., biopsy specimens). The data further support that oncogenic PIK3CA may play a critical role in pharyngeal carcinogenesis, and the mutant-enriched sequencing methods for PIK3CA are sensitive and reliable ways to detect PIK3CA mutations in clinical samples. Because PIK3CA and its pathway are potential targets for chemotherapy and radiation therapy, and frequent somatic mutation of PIK3CA has been identified in many human cancer types (e.g., breast cancer, colorectal cancer), the abilities to detect PIK3CA mutations with enhanced sensitivities have great potential impacts on target therapies for many cancer types. ' 2007 Wiley-Liss, Inc.Key words: mutant-enriched sequencing method; PIK3CA oncogene; hot-spot mutation; pharyngeal cancer; HNSCC Oral and pharyngeal cancer accounts for over half a million new cancer cases and 2,710,000 deaths worldwide per annum. It is the sixth most common malignant tumors in the world. In the United States alone, there were 30,990 estimated new cancer cases and 7,430 new deaths in the oral cavity and pharynx in 2006. 1 Despite recent advances in surgical techniques and improvement in radiation therapy, the median survival of patients with head and neck cancer has changed little over the past few decades. 2 Thus, a better understanding of molecular and genetic feature of head and neck cancer would be critically helpful for the development of new methods for early diagnosis, monitoring and targeting therapy, and the eventual improvement in the survival rate. Recently, significant progress has been achieved in the understanding of the molecular genetic events underlying the development of oral squamous cell carcinoma, which includes inactivation of multiple tumor suppressor genes (p16, p53, p14 and FHIT) and activation of oncogenes (cyclin D1 and EGFR). 3,4 However, the molecular genetic profile of pharyngeal carcinogenesis is relatively less understood.PIK3CA, which is a member of PI3Ks family, has been demonstrated to function as an oncogene in some human ...