Preclinical studies have explored SL interactions with other DNA repair genes such as ATR, PALB2, and members of the FANC gene family,15 which can confer a BRCA-like status.15 Preclinical trials have shown positive outcomes and sensitivity when combining PARPi and ATR inhibitors in human ATR–deficient lung, prostate, and pancreatic cancer cells.61 Therefore, future trial designs should explore new combinations of therapies for long-tail alterations to detect new SLs. Here, PALB2 is linked to familial pancreatic carcinoma.