Patients with HRD-H had shorter PFS than those with HRD-L (2.43 vs. 5.45 months; p = 0.043), However, OS was not significantly different between these two groups (4.43vs.9.35 months; P = 0.11)....This study suggests that S-1 chemotherapy combined with anti-PD-1 McAb (Sintilimab) and anti-angiogenic drug (Anlotinib) is efficacy and safety as a second-line treatment for pancreatic cancer patients with liver metastasis. Subgroup analysis showed that patients with HRD-L had longer PFS. HRD-H were found to be related to worsen PFS, which may indicate that other therapies should be explored regarding to these patients.