AKT1 and pachyonychia congenita: The precise mechanisms underlying gemcitabine-induced resistance in PC remain largely unknown, although previous studies have suggested that epithelial-mesenchymal transition, aberrant gene expression, gene mutation, dysregulation of critical signaling pathways, such as the NF-κB and Akt signaling pathways, apoptosis, and the presence of stromal cells, highly resistant cells, and cancer stem cells are involved in the chemoresistance of PC [3‒6].