Inclusion Criteria:  Age≥18 years old and ≤80 years old. Histologically or cytologically confirmed local advanced/metastatic pancreas adenocarcinoma. Eligible histologic variants include adenocarcinoma or variants to include mucinous adenocarcinoma or adenosquamous carcinoma. Patient must have a tumor lesion that is amenable to a core needle biopsy. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Life expectancy of greater than 90 days, as judged by the investigator. Routine blood test: absolute neutrophil count>1500/mm3, platelet>100000/mm3. Normal liver function: serum total bilirubin≤2.0mg/dl, alanine aminotransferase (ALT) and aspertate aminotransferase (AST) <2.5 times of the upper limit of normal value. Normal kidney function: serum creatinine<1.5 times of the upper limit of normal value or creatinine clearance rate>45ml/min. The pancreatic cancer organoid were cultured successfully. No severe comorbidities.  Exclusion Criteria:  Patients with poor condition can not tolerate chemotherapy and targeted therapy. Impaired organ functions: heart failure (New York Heart Association III-IV), coronary heart disease, myocardial infarction within 6 months, severe cardiac arrhythmia and respiratory failure. Patients diagnosed with other cancer within 5 years. Patients who are pregnant or breastfeeding. Patients enrolled in other clinical trials or incompliant of regular follow up. Patients who did not provide an informed consent.