Exosomes from pancreatic cancer cells reduced myosin heavy chain (MHC) expression by activating the P38/CEBPβ/UBR2/Atrogin1 signaling pathway in skeletal muscle cells, leading to muscular duct atrophy and muscle weight loss in the cachexia model of mice with in situ pancreatic cancer [91]. Here, HLA-C is linked to familial pancreatic carcinoma.