Ms. Xu was a 77-year-old female, who was diagnosed with mPDAC in January 2022 and had KRAS G12V, TP53, and APC mutations. She was treated with GS (gemcitabine plus S-1) and GnP regimens as first-, and second-line therapy, and the PFS was 22 and 12 weeks, respectively. Then, she received trametinib (1 mg once daily) in combination with HCQ (200 mg once daily). After 8 weeks of treatment, CT scans revealed that the number and diameter of liver metastases increased (Fig. 2). She was lost to follow-up after her last radiographic evaluation.