CD274 and gastric cancer: In particular, in patients with tumors expressing PD-L1 with CPS ≥5, nivolumab plus chemotherapy showed statistically significant improvements in both OS and PFS in comparison with chemotherapy alone.32 Based on the results of the CHECKMATE-649 trial, the European Medicines Agency validated40 and the US FDA accepted for priority review41 the application of nivolumab combined with chemotherapy as first-line treatment in metastatic GC, GEJ cancer, and esophageal adenocarcinoma.