Moreover, the chemotherapeutic agent gemcitabine/Gemzar/2′,2′-difluorodeoxycytidine increased the expression and secretion of miR-146a/MicroRNA 146a and SNAI1/Snail in exosomes derived from cancer-associated fibroblasts, allowing pancreatic cancer recipient cells to proliferate and develop drug resistance (45). This evidence concerns the gene SNAI1 and familial pancreatic carcinoma.