As per NCCN Guidelines for pancreatic adenocarcinoma version 3.2024, potentially actionable targets for PDAC include fusions (ALK, NRG1, NTRK, ROS1, FGFR2, and RET), mutations (BRAF, BRCA1/2, KRAS, and PALB2), amplifications (HER2), microsatellite instability (MSI), mismatch repair deficiency (dMMR), or tumor mutational burden (TMB) via an FDA-approved and/or validated NGS-based assay [27]. This evidence concerns the gene PALB2 and hyperinsulinemic hypoglycemia, familial, 4.