Moreover, exosomal miR-301a-3p derived from hypoxic pancreatic cancer cells promoted macrophage M2 polarization through downregulation of PTEN expression and activating PI3Kγ signaling pathway, triggering the secretion of TGF-β, IL-10, and arginase from pancreatic cancer cells, which in turn facilitated EMT and lung metastasis [97]. Here, PTEN is linked to familial pancreatic carcinoma.