SMAD4 and pancreatic neoplasm: Recent studies have implicated elevated LAMA3 expression in various types of tumors, where it appears to promote cell proliferation, apoptosis, and tumor progression by modulating signal transduction pathways.7, 8, 9 Zboralski et al. demonstrated the simultaneous functional inactivation of the tumor suppressor mothers against decapentaplegic homolog 4 (SMAD4) and invasive growth of tumors in rectal and pancreatic cancers.