Since the SMAC moiety of our cancer-targeted small molecule drug conjugate SW IV-134 displaces XIAP from its designated caspases (3/7 and 9), leading to their activation [23, 24], we hypothesized that SW IV-134 would also improve the sensitivity of pancreatic cancer cells to gemcitabine, known to develop resistance against this chemotherapeutic [25, 26]. Here, XIAP is linked to cancer.