The most recent FDA approval related to BTC came in October 2023 with an expanded indication for pembrolizumab to be used in combination with gemcitabine (Gemzar) and cisplatin for the treatment of locally advanced unresectable or metastatic BTC. This was based on the phase III KEYNOTE-966 trial that found patients treated with this combination therapy had a median overall survival of 12.7 months compared to 10.9 months for those who received a placebo with chemotherapy.