Pancreatic carcinogenesis - several small steps or one giant leap?

Pancreatic ductal adenocarcinoma (PDAC) is thought to develop through the stepwise accumulation of cancer gene mutations. A new study suggests that 16% of PDACs exhibit genetic rearrangements that simultaneously altered two or more cancer driver genes. These findings challenge the current models of PDAC development, but arguably remain compatible with a stepwise tumour progression.