KRAS and familial pancreatic carcinoma: Pancreatic cancer typically starts as a precancerous lesion, i.e., a pancreatic intraepithelial neoplasia (PanIN), which accumulates gene mutations over time, ultimately progressing to a more dysplastic state.16–18 Approximately 90% of pancreatic cancers of all grades have activating oncogenic Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations.