AKT1 and permanent neonatal diabetes mellitus-pancreatic and cerebellar agenesis syndrome: Previous studies have suggested a variety of mechanisms of chemoresistance in PaCa, including the deregulation of key signaling pathways (such as NF-κB [28], phosphatidylinositol 3-kinase [PI3K]/Akt [29]), epithelial-mesenchymal transition (EMT) [30] and the presence of stromal cells [31].