Reciprocal communication between cancer cells and stromal cells induces changes in cellular components of the pancreatic tumor microenvironment, which can prime the primary tumor for metastasis and cell migration.145 Primary pancreatic tumors can modulate the local microenvironment in metastatic sites by secreting exosomes and soluble factors to promote colonization.146,147 Various stromal cells, e.g., TAMs, also participate in angiogenesis and metastasis of pancreatic cancer via the secretion of VEGF, CXCL1, and CXCL8.148,149. The gene discussed is CXCL1; the disease is familial pancreatic carcinoma.