Genetic alterations in Hedgehog pathway components, including mutations in SMO and amplifications of GLI1 and GLI2 (downstream transcription factors), contribute to the expression of proproliferative and antiapoptotic genes such as Myc, Bcl-2, and Sox2. Importantly, Hedgehog signaling engages in crosstalk with other pathways, particularly K-Ras and Notch, thereby influencing the behavior of pancreatic cancer cells (78). Here, KRAS is linked to familial pancreatic carcinoma.