Concerning germline alterations, our results further support the current National Comprehensive Cancer Network guidelines recommending routine screening for germline variants in patients with PDAC at diagnosis, regardless of age, ancestry, and family or personal history of cancer, including not only BRCA1/2 but also ATM, CDKN2A, PALB2, STK11, TP53, MLH1, MSH2, MSH6, and PMS2. 20 Based on our findings, FANC genes and CHEK2 should be added to that list. This evidence concerns the gene PALB2 and cancer.