Hello @whrdds, Im sorry to hear that insurance is stepping into the way of your treatment. That is intensely frustrating. Has your doctor done an appeal to consult with an actual medically educated individual with the insurance? I had SCC deep in my ear 13 years ago and it had invaded bone so a temporal bone resection was done with chemo/radiation. I later had lung mets which were resected. My most recent met was to my kidney and associated lymph nodes in 2020. My Mayo oncologist started Libtayo, which works along the same pathway as Keytruda. The kidney met and lymph nodes disappeared on this treatment and after 27 months on the infusions, she recommended "taking a holiday" from the drug. I was having poor appetite and tiredness as side effects. My last scan 2 weeks ago was still clear after being off the drug for over 2 years. If and when a new metastasis shows up, we will restart the infusions. Their cost is incredible so I understand out of pocket is impossible. I had no issues with Medicare or secondary insurance coverage while I was on Libtayo. I assume that it will be approved if I need to go back on it, as it worked so well. I do many supplements and treatments to keep my immune system supported since it is what is keeping me alive vs this cancer. I hope you have similar good results if you have to take a "holiday" from Keytruda. Keep after that insurance company though, as they should not be making treatment decisions for us.