Based on the results of the KEYNOTE-590 and CheckMate-648 trials, the US Food and Drug Administration (FDA) approved that immune checkpoint inhibitors, pembrolizumab and nivolumab combined with chemotherapy and dual immunotherapy, ipilimumab-nivolumab, treat ESCC patients as first-line therapy, regardless of PD-L1 expression [12,13,14]. The gene discussed is CD274; the disease is esophageal squamous cell carcinoma.