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Critical Reviews™ in Oncogenesis
SJR: 0.631 SNIP: 0.503 CiteScore™: 2

ISSN 印刷: 0893-9675
ISSN オンライン: 2162-6448

Critical Reviews™ in Oncogenesis

DOI: 10.1615/CritRevOncog.2019031641
pages 199-212

Gemcitabine: A Review of Chemoresistance in Pancreatic Cancer

Deepika Sarvepalli
Department of Internal Medicine, AdventHealth, Orlando, FL 32804
Mamoon Ur Rashid
Department of Gastroenterology, Cleveland Clinic, Weston, Florida; Department of Internal Medicine, AdventHealth, Orlando, FL 32804
Asad Ur Rahman
Abington Hospital−Jefferson Health, Abington, Pennsylvania
Waqas Ullah
Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa, Pakistan; Abington Hospital - Jefferson Health, Abington, PA 19001, USA
Ishtiaq Hussain
Abington Hospital−Jefferson Health, Abington, Pennsylvania; Department of Gastroenterology, Cleveland Clinic, Weston, FL 33331
Badar Hasan
Abington Hospital−Jefferson Health, Abington, Pennsylvania
Sundas Jehanzeb
Khyber Teaching Hospital, Peshawar, Khyber Pakhtunkhwa 25000, Pakistan
Abdul Kareem Khan
Department of Internal Medicine, AdventHealth, Orlando, FL 32804
Akriti Gupta Jain
Department of Internal Medicine, AdventHealth, Orlando, Florida
Neelam Khetpal
Department of Internal Medicine, AdventHealth, Orlando, Florida
Sarfraz Ahmad
Department of Gynecologic Oncology, AdventHealth Cancer Institute, Orlando, FL 32804


Pancreatic ductal adenocarcinoma, an exocrine tumor, is the most common type of cancer of the pancreas and one of the top five most prominent causes of cancer-associated mortality worldwide. The survival rate for pancreatic cancer is sadly less than 8%. The high fatality rate is partly related to late diagnosis and partly to the aggressive nature of malignant cells that disseminate to nearby tissues at an early stage of the disease, making treatment difficult. Available treatment choices consist of both medical and surgical: removal of the tumor, use of various medications like chemotherapeutic drugs and immunotherapeutic agents, radiation therapy, and targeted drug therapy. Since most patients suffer from advanced cancer at the time of diagnosis, chemotherapy becomes the primary therapeutic option in such cases. Drugs like Gemcitabine, Abraxane, FOLFIRINOX, and newer combination therapies are all effective in management, either curatively or palliatively. However, chemoresistance poses a significant challenge. Several factors, both intrinsic and acquired, are involved in drug resistance. Here, we review the mechanism of action of the first-line chemotherapy drugs in pancreatic cancer and various factors associated with cancer chemoresistance.


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Krishna Patel, Maya Nair, Riyaz Basha, Sohail Siraj, Jamboor K. Vishwanatha, Chloe Smith
Noncoding RNAs (ncRNA) in Hepato Cancer: A Review
Journal of Environmental Pathology, Toxicology and Oncology, Vol.37, 2018, issue 1
Xiujuan Sun, Anshoo Malhotra
Lessons Learned from Gemcitabine: Impact of Therapeutic Carrier Systems and Gemcitabine’s Drug Conjugates on Cancer Therapy
Critical Reviews™ in Therapeutic Drug Carrier Systems, Vol.34, 2017, issue 1
Sathish Dyawanapelly, Animesh Kumar, Manish K. Chourasia
New Prospectives of Prostate Cancer Gene Therapy: Molecular Targets and Animal Models
Critical Reviews™ in Eukaryotic Gene Expression, Vol.11, 2001, issue 1-3
Chia-Ling Hsieh, Leland W. K. Chung