Under pathophysiological conditions (co-culture with macrophages, hypoxia, and lipid starvation), ADXA6/LRP1/TSP1 protein complex promotes PDA cancer aggressiveness; efficient uptake of CAF-derived EVs requires ADXA6; ADXA6+ EVs from CAFs improved recipient cancer cells’ migration; PDA patients were found to have elevated levels ADXA6+ EV in serum. Here, THBS1 is linked to Patent ductus arteriosus.