The global open-label Checkmate 648 trial [17] randomized 970 patients (Asian and western) with previously untreated metastatic ESCC to receive nivolumab (240 mg flat dose every two weeks) plus chemotherapy (5-fluorouracil plus cisplatin every four weeks), nivolumab (3 mg/kg every two weeks) and ipilimumab (1 mg/kg every six weeks), or chemotherapy alone, regardless the PD-L1 expression. The gene discussed is CD274; the disease is esophageal squamous cell carcinoma.