In an observation study of pancreatic cancer initiation and progression among smokers, it was found that nicotine promoted the development of KRAS mutation-induced pancreatic cancer, which reduced the expression of GATA6 by activating the AKT-ERK-MYC signaling pathway, which is essential for accelerating PDAC development (Hermann et al., 2014). This evidence concerns the gene AKT1 and pancreatic neoplasm.