An emerging metabolic target for the treatment of recalcitrant cancers, such as pancreatic adenocarcinoma (PDA), is their reliance on NAD+ synthesis, particularly through the nicotinamide-recycling pathway.1, 2, 3 Rapid and efficient NAD+ synthesis is critical to sustain signaling processes, such as deacetylation by sirtuins and adenosine diphosphate (ADP) ribosylation by poly(ADP ribose) polymerase 1 (PARP1). Here, PARP1 is linked to Patent ductus arteriosus.