The participation of the hypoxia-inducible factor 1α (HIF-1α)/signal transducer and activator of transcription 3 (STAT3) signaling pathway was investigated in GEM-resistant pancreatic cancer cells by mediating the expression of ZEB1 and TWIST1, thereby regulating GEM metabolic enzymes and contributing to GEM-resensitized cell death induction [34]. This evidence concerns the gene TWIST1 and pancreatic neoplasm.