Pancreatic polypeptide (PPY), a member of the neuropeptide Y (NPY) family, is known to inhibit gastric and intestinal function as well as insulin action.[31] Growing evidence has highlighted the association between aberrant gastrointestinal hormone secretion and PDAC development and progression.[32, 33, 34] Recently, elevated PPY levels have been linked to increased Ki67 staining in pancreatic cancer tissue, suggesting a role in PDAC progression.[35] However, the specific role of PPY in shaping the tumor immune microenvironment and its effects on CAFs remained unexplored. This evidence concerns the gene MKI67 and familial pancreatic carcinoma.