ATF4 and familial pancreatic carcinoma: In addition, PUM1 knockdown in pancreatic cancer cells activated the eukaryotic translation initiation factor 2 alpha kinase 3 (EIF2AK3/PERK)/eukaryotic initiation factor 2 (eIF2)/activating transcription factor 4 (ATF4) signaling pathway, inhibiting cell growth, invasion, and metastasis, and promoting apoptosis [22].