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I read with great interest the article by Mitsue Saito and colleagues.1 The study reported that cadonilimab combined with chemotherapy achieved remarkably strong antitumor activity (objective response rate (ORR), 81.4% and disease control rate (DCR), 97.7%) in 43 enrolled participants and may represent a promising first-line treatment option for patients with advanced esophageal squamous cell carcinoma (ESCC). Although this single-arm phase II trial met its primary endpoint (ORR), several important issues warrant further clarification.