DCK and pancreatic neoplasm: For pancreatic cancer cells, several studies reported that hypoxia induced resistance to gemcitabine, by altered signalling through PI3K/Akt/NF-κB pathways and partially through MAPK signalling pathway [37], by reducing both inhibition of proliferation and induction of apoptosis by gemcitabine [38], and by decreasing the synthesis of active gemcitabine deoxynucleotides, possibly also through downregulation of dCK [39].