The study by Xu et al. shows that ADM can enhance the migration and invasion of myelomonocytic cells by activating multiple signaling pathways, including MAPK, PI3K/Akt, and eNOS in pancreatic cancer, as well as promote myelomonocytic cells trans-endothelial migration through increased expression of VCAM-1 and ICAM-1. Here, VCAM1 is linked to familial pancreatic carcinoma.