The effect of metronomic gemcitabine on the immune system, however, has not been reported in the literature, although a recent study showed that conventional MTD gemcitabine regimen (3 weeks on, 1 week off) reduces CD8+ T cells, increases CD11c+ dendritic cells, but does not significantly alter the number of CD4+ T cells in pancreatic cancer patients after one cycle of treatment when compared with pre-treatment baseline (Soeda et al, 2009). This evidence concerns the gene ITGAX and familial pancreatic carcinoma.