Fig. 2.

Promoters of pancreatic carcinogenesis include smoking, obesity with associated hyperinsulinemia, and inflammation. p53 acts as a break in several steps of the pathophysiology that links these conditions to cancer progression. These steps include inhibition of NF-κB, inhibition of pro-carcinogenic effects of hyperinsulinemia, and decrease of mutation burden through its function as a guardian of genome integrity. TMB, tumor mutation burden.