SMAD4 and pachyonychia congenita: The 2011 phase II trial of the combination of cetuximab, GEM, and oxaliplatin followed by adjuvant chemoradiotherapy with cetuximab for locally advanced (T4) pancreatic adenocarcinomas demonstrated a correlation between immunostaining for Smad4(Dpc4) and the pattern of disease progression, suggesting that the expression of Smad4(Dpc4) has a predictive biomarker of value and may lead to personalized treatment strategies for patients with localized PC [151].