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Here we argue that allowing the use of pembrolizumab to any advanced solid tumor in any tumor type in any line of therapy for a fixed duration may be preferable to the current assortment of indications. The aggregate response rate in landmark clinical trials for approved indications of pembrolizumab is low and even lower in real-world populations. Due to heterogeneity of response to checkpoint inhibitors and limited predictive biomarkers, there are subsets of patients without approved indications for pembrolizumab that may have response to checkpoint inhibitors. The current regulatory framework of numerous overlapping clinical trials leading to complex approval indications is redundant and inefficient. We conclude that giving pembrolizumab in any metastatic solid tumor in any setting may lead to better outcomes with minimal increase in cost. Randomized clinical trials should focus more on optimal duration of treatment based on tumor type and initial response to checkpoint inhibitors.<\/jats:p>","DOI":"10.1007\/s00432-022-04412-4","type":"journal-article","created":{"date-parts":[[2022,10,22]],"date-time":"2022-10-22T04:02:54Z","timestamp":1666411374000},"page":"1357-1360","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Pembrolizumab for all"],"prefix":"10.1007","volume":"149","author":[{"given":"Myung S.","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay","family":"Prasad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,22]]},"reference":[{"key":"4412_CR6","unstructured":"Cost Information and Financial Help with Keytruda. 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(Royalties) Johns Hopkins Press, Medscape, MedPage. (Consulting) UnitedHealthcare. (Speaking fees) Evicore, New Century Health. (Other) Plenary Session podcast has Patreon backers.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}