Given that Nodal signaling drives self-renewal and tumorigenicity of CSCs, which constitute a pivotal subpopulation of metastatic tumor cells [40, 41], the decrease in pancreatic cancer distant metastasis caused by inhibition of Nodal signaling might be explained by the suppression of cancer cells reengineering in the primary tumor site and by a reduction in CSCs viability. This evidence concerns the gene NODAL and familial pancreatic carcinoma.