For the PD-L1 positive ESCC patients, ORR (22.0 vs 7.0%), DOR (9.3 vs. 7.7 months), mPFS (3.2 vs. 2.3 months; HR = 0.66, 95% CI: 0.48–0.92), and mOS (10.3 vs. 6.7, HR = 0.62, 95% CI: 0.46–0.90) were better in the pembrolizumab group compared with chemotherapy group. The gene discussed is CD274; the disease is esophageal squamous cell carcinoma.