Even in stage 2 presentations, pancreatic adenocarcinoma is considered a deadly disease. Overall from all stages only 7% of the patients survive for five years and almost all of those are from the lower stage presentations (stage 0-2b which represent 25% of all patients) and are also eligible for resection. In this population, only 25% survive. The causes of this dismal statistic are theorized to be the pancreatic cancer cells' propensity to form a protective stroma which blocks the action of

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... e most commonly used chemotherapy agents and also, the continued activation of protein pathways, specifically NF-κB that results in an inhibition of apoptosis. A recent study of high dose genistein in orthotopic mouse models indicated that this novel therapy may both retard stroma formation to a permeable level and also deactivate the Notch NF-κB pathway leading to increased apoptosis and the prevention of recurring disease. The case presented here is of a single patient given this novel treatment at full dosing as defined by the orthotopic study during the Gemzar phase of chemotherapy and continuing at a maintenance dose afterward for a period of five years. The patient survived with remarkably lower miR-21 and CA19-9 expression levels and no recurring disease. She remains disease free as of the date of this paper five years and ten months post resection. Thus the authors believe that further study of this effect is warranted.