reported that PSK suppressed Hedgehog signaling through down-regulation of mastermind-like protein 3 (MAML3) and recombination signal binding protein for immunoglobulin-kappa-J region (RBPJ) transcription under hypoxia, inhibiting the induction of a malignant phenotype in pancreatic cancer (113), which provides a new idea for the treatment of refractory pancreatic cancer. Here, MAML3 is linked to familial pancreatic carcinoma.