Background EO-PCa is increasingly recognized as a biologically distinct entity, but its clinical behavior, molecular features, and outcomes relative to LO-PCa are incompletely characterized. Methods The Tempus Lens Platform (Tempus AI, Inc., Chicago, IL) was used to query the de-identified, multimodal database for patients (pts) diagnosed with metastatic prostate cancer (N= 6,967) tested with Tempus xT (DNA-seq) and xR (RNA-seq).