For instance, exosomal circ-PDE8A, derived from pancreatic ductal adenocarcinoma, regulates metastasis-associated in colon cancer 1 (MACC1) expression by binding to miR-338, stimulating cancer cell invasive growth via the MACC/MET/extracellular regulated kinase (ERK) or protein kinase B (AKT) pathway, and the expression levels of exosomal circRNAs closely correlate with patient prognosis (Li et al., 2018). This evidence concerns the gene AKT1 and cancer.