The aim of our study was to examine the important role of the axis in pancreatic cancer (PaCa) cells’ relationship with stromal cells in gemcitabine-resistant (GEM-R) tumors and to confirm the effectiveness of CXCR4 antagonists for the treatment of GEM-R PaCa cells. The gene discussed is CXCR4; the disease is permanent neonatal diabetes mellitus-pancreatic and cerebellar agenesis syndrome.