The study focuses on understanding the molecular characteristics of borderline resectable pancreatic ductal adenocarcinoma (PDAC) and its role in cancer dissemination. Researchers isolated 36 organoids from primary tumor masses of PDAC patients with varying metastatic statuses. Whole-exome sequencing and RNA sequencing were conducted, along with assessing drug responses to 18 clinically relevant compounds. Findings indicate that borderline resectable PDAC organoids display distinct patterns related to their metastatic potential, influenced by genetic and transcriptional factors, along with significant variations in drug responses.