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The product projected to be the biggest seller in 2024 may be a little predictable. Merck & Co.’s anti-PD1 monoclonal antibody (mAb) Keytruda (pembrolizumab) sits with an unassailable lead at the top of the prospective 2024 league table with sales of more than US$27 billion worldwide (Table 1). This is more than double the sales of most other products in the top 10 and largely reflective of the situation at the end of 2022 when looking ahead to 2023. In fact, this could be the scenario for several years to come given the clinical success of Keytruda in a wide range of cancers. The latest forecasts see Keytruda sales continuing to grow until at least 2027, with patent expiry in 2028 potentially opening the door to biosimilars. The product is also in development or under regulatory review for an array of new indications with the potential to add yet more sales. Keytruda’s closest competitor in the PD1/PD-L1 space, Bristol Myers Squibb’s Opdivo (nivolumab), also features in the top 10 at number seven with sales forecasts for 2024 of more than $11 billion.