Alternatively, pembrolizumab (anti-PD1) can be used (alone or with CT: cisplatin + 5-FU) as first-line therapy since the phase III randomized study demonstrated improved OS with pembrolizumab alone in patients whose tumor expresses PD-L1 (combined positive score: CPS ≥ 1) or with pembrolizumab + CT independently of PD-L1 tumor expression [95]. Here, CD274 is linked to neoplasm.