Approximately 20% of PAAD patients have germline and somatic mutations in genes involved in DNA damage repair, such as BRCA1, BRCA2, MSH2, MSH6, MLH1, FANCF, and PALB2, all of which are involved in homologous recombination repair or mismatch repair (39). This evidence concerns the gene BRCA1 and pancreatic adenocarcinoma.