On October 22, 2026, the U.S. FDA announced traditional approval of pembrolizumab (Keytruda) and pembrolizumab with berahyaluronidase alfa-pmph (Keytruda Qlex) for adult and pediatric patients with unresectable or metastatic TMB-H solid tumors that progressed after prior treatment and lack satisfactory alternatives. This approval expands therapeutic options for systemic cancer therapy in this patient population and underscores ongoing advancements in precision oncology driven by tumor mutational burden markers.