Although the mechanism or direct temporal cause-result relationship between chemoresistance and the expression of ALDH1A1 and ALDH3A1 was not addressed in this experiment, the role of NRF2 in pancreatic cancer cell survival is evident by modulating the expression of these drug metabolizing enzymes including possibly ALDH1A1, ALDH3A1 and other potent downstream target of NRF2 [37,44]. This evidence concerns the gene ALDH1A1 and familial pancreatic carcinoma.