The gene mutational landscape revealed, over the already known key drivers specifically associated with pancreatic NETs, pancreatic NECs [11, 66] and MTCs [6], a common signature represented by a set of genes most frequently mutated, among which those involved in genome stability maintenance and DNA damage recombination emerged, including MDC1, BRCA1 and ATM. Here, ATM is linked to pancreatic endocrine carcinoma.