Among the HR-DDR genes, the genes that most frequently have variations include ATM, BRCA1/2, and PALB2. 6 Germline variations in the BRCA1/2 genes may cause double-strand DNA damage repair deficiency and are associated with risk for pancreatic cancer.16 The Pancreas Cancer Olaparib Ongoing trial7 detected BRCA1/2 variations in 2167 patients with metastatic pancreatic cancer. The gene discussed is PALB2; the disease is familial pancreatic carcinoma.