In this randomized, double-blind, multicenter phase 3 study, patients with...PD-L1–positive ESCC who had no prior systemic antitumor therapy were randomized 2:1 to receive serplulimab 3 mg/kg or placebo plus chemo (5-FU + cisplatin)....Median OS was significantly longer in the serplulimab-chemo group than the placebo-chemo group (14.6 vs 11.2 months; hazard ratio [HR] 0.70, 95% CI 0.57–0.86; P = 0.0006)....Efficacy improvements were also observed in confirmed objective response rate (58.7% vs 42.1%) and duration of response (median, 7.1 vs 4.6 months)....With another 9.3 months of follow-up, the encouraging efficacy and manageable safety of serplulimab plus chemo as first-line treatment in patients with PD-L1–positive advanced ESCC were maintained...