ASPH and familial pancreatic carcinoma: In pancreatic cancer, ASPH enhances the secretion of exosomes from MIA-Paca2 cells, which carry components, like MMP2, that promote invasion/metastasis and immunosuppression via activating the ASPH-Notch signaling pathway, therefore leading to pulmonary metastasis in patient derived xenograft (PDX) murine models (Fig. 1) [55].