In pancreatic cancer, NAM suppressed proliferation, cell cycle progression, invasion, and enhanced apoptosis in vitro by down-regulating SIRT1, KRAS (Kirsten Rat Sarcoma), and p-AKT (phosphated protein kinase B) [130], while it exhibited an analogous effect when administered in combination with valproate [129]. The gene discussed is SIRT1; the disease is familial pancreatic carcinoma.