The following are representative examples of putative resistance mechanisms; NF-κB and PI3K/Akt pathway activation in pancreatic and breast cancer [5,6] the up-regulation of anti-apoptotic Bcl-2 protein in pancreatic cancer [7,8] the deficiency of human equilibrate nucleoside transporter 1 in NSCLC [9]and alterations of gemcitabine metabolizing enzymes [10-13]. This evidence concerns the gene NFKB1 and familial pancreatic carcinoma.