S-1 has been selected as a candidate to be investigated in combination with gemcitabine in patients with pancreatic cancer because of its consistent activity as a single agent in this disease and because of the lack of cross-resistance between gemcitabine and 5-FU derived from S-1, as suggested by the observed activity of gemcitabine in patients refractory to 5-FU (Rothenberg et al, 1996). The gene discussed is PSMD1; the disease is familial pancreatic carcinoma.