{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:11:58Z","timestamp":1777896718635,"version":"3.51.4"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R37CA262209"],"award-info":[{"award-number":["R37CA262209"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Undifferentiated carcinoma (UC) is a rare subtype of pancreatic cancer distinguished from UC with osteoclast-like giant cells (UC-OGC) in 2019, affecting interpretation of literature that does not distinguish these subtypes. We sought to identify translationally relevant differences between these 2 variants and compared with pancreatic ductal adenocarcinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We characterized clinical and multiomic differences between UC (n\u2009=\u200932) and\u00a0UC-OGC (n\u2009=\u200915) using DNA sequencing, RNA sequencing, and multiplex immunofluorescence and compared these findings with pancreatic ductal adenocarcinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Characteristics at diagnosis were similar between UC and UC-OGC, though the latter was more resectable (P\u2009=\u2009.009). Across all stages, median overall survival was shorter for UC than for UC-OGC (0.4\u00a0years vs 10.8\u2009years, respectively; P\u2009=\u2009.003). This shorter survival was retained after stratification by resection, albeit without statistical significance (1.8\u00a0years vs 11.9\u2009years, respectively; P\u2009=\u2009.08). In a subset of patients with available tissue, the genomic landscape was similar among UC (n\u2009=\u20099), UC-OGC (n\u2009=\u20095), and pancreatic ductal adenocarcinoma (n\u2009=\u2009159). Bulk RNA sequencing was deconvoluted and, along with multiplex immunofluorescence in UC (n\u2009=\u200913), UC-OGC (n\u2009=\u20095), and pancreatic ductal adenocarcinoma (n\u2009=\u200916), demonstrated statistically significantly increased antigen-presenting cells, including M2 macrophages and natural killer cells, and decreased cytotoxic and regulatory T cells in UC and UC-OGC vs pancreatic ductal adenocarcinoma. Findings were similar between UC and UC-OGC , except for decreased regulatory T cells in UC-OGC (P\u2009=\u2009.04).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this series, UC was more aggressive than UC-OGC, with these variants having more antigen-presenting cells and fewer regulatory T cells than pancreatic ductal adenocarcinoma, suggesting potential for immune-modulating therapies in the treatment of these pancreatic cancer subtypes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkae097","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T04:55:14Z","timestamp":1728017714000},"source":"Crossref","is-referenced-by-count":2,"title":["Characterization of undifferentiated carcinomas of the pancreas with and without osteoclast-like giant 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MI,","place":["USA"]},{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8254-5404","authenticated-orcid":false,"given":"Aaron M","family":"Udager","sequence":"additional","affiliation":[{"name":"University of Michigan Rogel Cancer Center , Ann Arbor, MI,","place":["USA"]},{"name":"Department of Pathology, University of Michigan , Ann Arbor, MI,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-0404","authenticated-orcid":false,"given":"Timothy","family":"Frankel","sequence":"additional","affiliation":[{"name":"University of Michigan Rogel Cancer Center , Ann Arbor, MI,","place":["USA"]},{"name":"Department of Surgery, University of Michigan , Ann Arbor, MI,","place":["USA"]},{"name":"VA Ann Arbor Healthcare System , Ann Arbor, 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