ArticleNPJ precision oncology2026
Dual pancreatic carcinomas: clonally related or independent primaries?
Article in NPJ precision oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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27 authors.
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Abstract
Dual pancreatic cancers, either synchronous or metachronous in presentation, are a rare occurrence. It remains unclear if these lesions are clonally related or independently occurring primary malignancies. Herein we present a cohort (N = 22) with dual pancreatic ductal adenocarcinoma (PDAC) tumors to resolve previously conflicting reports and interrogate the underlying biological and clinical characteristics of this patient population. Next-generation sequencing of paired lesions (N = 10) revealed that while most dual PDAC are clonally related, independently occurring lesions do occur, irrespective of the interval between lesions. Integrated clinical, genomic, and histopathological analyses revealed a high frequency of lymph node-negative, intraductal papillary mucinous neoplasm (IPMN)-associated cancers, KRAS and/or SMAD4 wild-type tumors, and classical subtype by immunohistochemistry, all collectively associated with more favorable outcomes. Acknowledging the highly selected nature of this cohort, isolated intrapancreatic metastases demonstrate a more indolent biology and these patients may benefit from personalized management approaches beyond traditional paradigms.
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