However, PAK4 activation is required for Akt-mediated NF-kB activation and maximal stimulation in pancreatic cancer cells [68,176], for Akt-induced chemoresistance in cervical or gastric cancer cells [45,177], for Akt-mediated enhanced proliferation/invasion in breast cancer cells [178] and for a number of other Akt-stimulated changes in other tumors [179,180]. The gene discussed is PAK4; the disease is familial pancreatic carcinoma.