Exosomes shed by pancreatic cancer cells can be internalized by CD14+ monocytes and impart a monocytic MDSC phenotype by downregulating HLA-DR expression and activating signal transducer and activator of transcription 3 (STAT3) signaling, with increased arginase I and ROS production as a result [153]. Here, STAT3 is linked to familial pancreatic carcinoma.