TP53 and metastatic neoplasm: In patients with metastatic disease and known KRAS, TP53, and CDKN2A mutation status (n = 232), we classified four distinct molecular subtypes of metastatic PDAC (Fig. 5c): (1) KRAS mutant predominant (KRAS mutant, TP53 wildtype/CDKN2A wildtype) (n = 46/232), (2) TP53 mutant predominant (TP53 mutant, KRAS mutant or wildtype/CDKN2A wildtype) (n = 127/232), (3) CDKN2A mutant predominant (CDKN2A mutant, KRAS mutant or wildtype/TP53 mutant or wildtype) (n = 41/232), and (4) triple negative (all KRAS, TP53, and CDKN2A wildtype) (n = 18/232).