Prostate specific antigen (PSA) degrades IGFBP5 to increase IGF bioavailability, the predominant growth factor in the bone microenvironment, which may potentiate pancreatic cancer cell survival and metastasis, although to date this mechanistic work has been restricted to 3T3 fibroblasts and not human cancer cells (30). Here, IGF1 is linked to familial pancreatic carcinoma.