When cells harbor an oncogenic mutation (e.g. KRAS mutation), this normal acinar-to-ductal metaplasia (ADM) response is derailed and initiates a sequence of events that can ultimately lead to pancreatic ductal adenocarcinoma (Kopp et al. 2012), a highly lethal cancer for which few treatment options exist. The gene discussed is KRAS; the disease is pancreatic ductal adenocarcinoma.