Multiple retrospective studies have shown that long-term metformin use is associated with a reduced risk of pancreatic cancer, potentially mediated by metformin’s activation of AMP-activated protein kinase (AMPK) and inhibition of mammalian target of rapamycin (mTOR) signaling by metformin, thereby modulating autophagy (26–28). Here, MTOR is linked to pancreatic neoplasm.