Abstract
Pancreatic cancer (PC) is a multigenic stromal disease with a high mortality rate. Gemcitabine is a widely prescribed drug for conventional chemotherapies. However, the usage of gemcitabine has been limited due to the resistance developed in tumor cells. Combining gemcitabine with other drugs such as platinum, celecoxib, erlotinib, and bevacizumab is found effective. However, these combination regimens were found to have toxic side effects and lead to poor survival due to activation of hypoxia inducible factor-1 alpha and nuclear factor kappa-B. Transcription factors also play a crucial role in resistance and tumor recurrence. Therefore, researchers are now focused on investigating novel drugs to reduce tumor recurrence and metastasis without toxic side effects. The current review discussed the gemcitabine structure, metabolism and mechanism of action on PC growth, resistance, and signaling.
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