SIRT3 and familial pancreatic carcinoma: However, pancreatic cancer cell lines, as well as cells obtained from pancreatic tumor patients, have been found to have the faulty signaling pathway of activation of the major transcription factor that orchestrates antioxidative response (SIRT3-NRF2-ARE pathway), with a decreased level of SIRT3, paradoxically highly activated NRF2, but the very low activity of MnSOD [56–60].