Multiple signaling pathways and downstream proteins such as phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR), nuclear factor-κB, and mitogen-activated protein kinases are involved in GEM resistance in pancreatic cancer. The gene discussed is AKT1; the disease is familial pancreatic carcinoma.