TLR4 and familial pancreatic carcinoma: It is worth mentioning that TAMs can promote chemoresistance by producing insulin-like growth factors (IGF)-1 and -2, which bind and activate IGF receptors on pancreatic cancer cells [162], as well as by releasing resistin, which binds to adenylyl cyclase-associated protein 1 (CAP-1) and Toll-like receptor 4 (TLR-4) on cancer cells, leading to refractory responses towards GEM treatments [163] (Figure 2).