This receptor, along with β-adrenergic receptors, also mediates NNK activation of cellular signals including the enzyme cyclooxygenase-2 (COX2), epidermal growth factor receptor (EGFR) and extracellular-signal-regulated kinases (ERK) in pancreatic cancer cells and ductal cells [65,66]. This evidence concerns the gene EGFR and familial pancreatic carcinoma.