{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T10:52:05Z","timestamp":1793962325530,"version":"4.8.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K08 CA259456"],"award-info":[{"award-number":["K08 CA259456"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000982","name":"Conquer Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000982","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006293","name":"American Society of Clinical Oncology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006293","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Career Development Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Previous research demonstrates longer survival for patients with lung-only metastatic pancreatic adenocarcinoma (mPDAC) compared to liver-only mPDAC. The objective of this study is to understand the survival differences, impact of chemotherapy, and associated genomic features of mPDAC that is isolated to either the liver or lung.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients and methods<\/jats:title>\n                  <jats:p>Longitudinal clinical outcomes and molecular sequencing data were retrospectively analyzed across 831 patients with PDAC across all stages whose tumors first metastasized to the liver or lung. Survival differences were evaluated using Cox regression. Mutational frequency differences were evaluated using Fisher\u2019s exact test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median overall survival (mOS) was shorter in patients with liver-only metastasis (1.3y [1.2-1.4], n\u2005=\u2005689) compared to lung-only metastasis (2.1y [1.9-2.5], n\u2005=\u2005142) (P\u2005=\u2005.000000588, HR\u2005=\u20052.00 [1.53-2.63]. Survival differences were observed regardless of choice of 1st-line standard-of-care therapy. For 5-fluorouracil-based therapies, mOS for liver-only mPDAC was 1.4y [1.3-1.6] (n\u2005=\u2005211) compared to 2.1y [1.8-3.3] for lung-only mPDAC (n\u2005=\u2005175) (P\u2005=\u2005.008113, HR\u2005=\u20051.75 [1.16-2.65]). For gemcitabine\/nab-paclitaxel therapy, mOS for liver-only mPDAC was 1.2y [1.1-1.5] (n\u2005=\u2005175) compared to 2.1y [1.6-3.4] for lung-only disease (n\u2005=\u200532) (P\u2005=\u2005.01863, HR\u2005=\u20051.84 [1.11-3.06]). PDAC tumors with liver-only metastases were modestly enriched (unadjustable P\u2005&amp;lt;\u2005.05) for: TP53 mutations, MYC amplifications, inactivating CDK2NA alterations, inactivating SMAD alterations, and SWI\/SWF pathway mutations. PDAC tumors with lung-only metastases were enriched for: STK11 mutations, CCND1 amplifications, and GNAS alterations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Patients with lung-only mPDAC demonstrate an improved prognosis relative to those with liver-only mPDAC. Responses to chemotherapy do not explain these differences. Organotropic metastatic tumor diversity is mirrored at the molecular level in PDAC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf007","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:48:24Z","timestamp":1741862904000},"source":"Crossref","is-referenced-by-count":9,"title":["Clinical outcomes and molecular characteristics of lung-only and liver-only metastatic pancreatic cancer: results from a real-world evidence database"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3074-6166","authenticated-orcid":false,"given":"Abrahm","family":"Levi","sequence":"first","affiliation":[{"name":"Cedars-Sinai Medical Center , Los Angeles, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5609-3849","authenticated-orcid":false,"given":"Edik","family":"Blais","sequence":"additional","affiliation":[{"name":"Perthera Inc., McLean 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Arizona College of Medicine, Hematology and Oncology , Tucson, AZ ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Couric","family":"Wadlow","sequence":"additional","affiliation":[{"name":"Inova , Fairfax, VA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"DeArbeloa","sequence":"additional","affiliation":[{"name":"Perthera Inc., McLean , VA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn McCormick","family":"Matrisian","sequence":"additional","affiliation":[{"name":"Pancreatic Cancer Action Network , Manhattan Beach, CA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Petricoin","sequence":"additional","affiliation":[{"name":"Perthera Inc., McLean , VA ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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