Pan et al. indicated that PBI-05204, a modified supercritical CO2 extract of Nerium oleander, markedly enhanced the antitumor efficacy of gemcitabine in a human pancreatic cancer PANC-1 orthotopic model and human pancreatic cancer cell lines, through downregulation of PI3k/Akt and mTOR pathways [33]. This evidence concerns the gene AKT1 and familial pancreatic carcinoma.