Furthermore, patients with PC as well as low expression of DLL4 and HES1 exhibit better survival compared to those with high expression.107,108 Low DLL4 abundance in tumor cells can predict the benefits of GEM adjuvant therapy after PDAC resection, and inhibiting DLL4/Notch signaling may represent a novel approach for PC therapy.109,110. This evidence concerns the gene HES1 and pachyonychia congenita.