For example, pembrolizumab is the only anti-PD-1 immune checkpoint inhibitor approved for a breast cancer indication by the MHRA16 (table 1), likely due to lack of complete late-stage clinical trials with large sample sizes investigating the efficacy of the other three anti-PD-1 immune checkpoint inhibitors.20 21 Similarly, although nivolumab and pembrolizumab both have colorectal cancer indications, there are differences in the characteristics of the patient populations these drugs are approved to treat15 16 (table 1, online supplemental table 1). This evidence concerns the gene PDCD1 and breast carcinoma.