While the broader CREB3 family plays known roles in cancer biology and ER homeostasis—and CREB1 is implicated in pancreatic cancer progression and β-cell differentiation—CREB3L4 remains largely unexplored in pancreatic disease and is not currently recognized as a biomarker or functional regulator in either PDAC or chronic pancreatitis [61]. Here, CREB1 is linked to familial pancreatic carcinoma.