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A phase II clinical trial conducted in 2013–2017 to evaluate the pharmacological treatment of advanced pancreatic ductal carcinoma showed that the autophagy inhibitor HCQ in combination with paclitaxel or gemcitabine resulted in significantly higher overall remission rates in patients [170], but more recent studies have suggested that cancer cells have evolved macropinocytosis (MP) to target and inhibit protective autophagy therapies [171]