The observed alterations in Bcl-XL, Bad and E2F1 expression following CaSm induction provide a possible mechanism behind CaSm-mediated chemoresistance, particularly as these genes have been previously implicated in gemcitabine resistance in PC and other cancers.29, 30, 31 Further work is needed to determine whether the addition of Bad and E2F1 or reduction of Bcl-XL can rescue gemcitabine sensitivity in the CaSm-overexpressing Panc-1 cells. This evidence concerns the gene E2F1 and pachyonychia congenita.