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. 2017 Dec 1;49(12):e406. doi: 10.1038/emm.2017.255

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Copyright © 2017 The Author(s)

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/

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The intrinsic and extrinsic mechanisms of gemcitabine (GEM) resistance. Intrinsic resistance refers to modification of transport mechanisms and the metabolism of the drug and activation of intracellular antiapoptosis pathways. Extrinsic resistance is primarily due to impairment of drug delivery.