However, gemcitabine can further increase the already high levels of Nrf2 which could also enable pancreatic cancer cells to withstand ROS accumulation to cause a chemoresistant pancreatic cancer phenotype; in addition, Nrf2 inactivation is associated with the sensitization of cancer cells to chemotherapy-induced killing in a mechanistic manner [13, 14]. This evidence concerns the gene NFE2L2 and familial pancreatic carcinoma.