TGFBR1 and familial pancreatic carcinoma: Moreover, inhibitors of the ALK5 kinase augmented the cytotoxicity of gemcitabine in both parental and gemcitabine-resistant pancreatic cancer cells [34], and Galunisertib, the first-in-class, first-in-human, oral small-molecule ALK5 inhibitor that enters clinical development in combination with gemcitabine, improved overall survival vs. gemcitabine alone in patients with unresectable pancreatic cancer [35].