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Novel strategies exhibiting promising effects in preclinical or phase I\/II clinical trials are often situated in an embarrassing condition owing to the disappointing results in phase III trials. The efficacy of the current therapeutic regimens is consistently compromised by the mechanisms of drug resistance at different levels, distinctly more intractable than several other solid tumours. In this review, the main mechanisms of drug resistance clinicians and investigators are dealing with during the exploitation and exploration of the anti-tumour effects of drugs in PDAC treatment are summarized. Corresponding measures to overcome these limitations are also discussed.<\/jats:p>","DOI":"10.1042\/bsr20200401","type":"journal-article","created":{"date-parts":[[2020,7,30]],"date-time":"2020-07-30T07:26:20Z","timestamp":1596093980000},"update-policy":"https:\/\/doi.org\/10.1042\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Mechanisms of drug resistance of pancreatic ductal adenocarcinoma at different levels"],"prefix":"10.1042","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0795-8409","authenticated-orcid":false,"given":"Jiali","family":"Du","sequence":"first","affiliation":[{"name":"Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, P.R.China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jichun","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, P.R.China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1898-0409","authenticated-orcid":false,"given":"Ji","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, P.R.China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"288","published-online":{"date-parts":[[2020,7,30]]},"reference":[{"key":"2021111620215298600_B1","article-title":"Cancer Stat Facts: Pancreatic Cancer","author":"National Cancer Institute","year":"2008"},{"key":"2021111620215298600_B2","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1146\/annurev.pathmechdis.3.121806.154305","article-title":"Pancreatic cancer","volume":"3","author":"Maitra","year":"2008","journal-title":"Annu. 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