An exploratory multicenter biomarker analysis identified plasma lncRNA RIME as a potential marker to refine who benefits from first-line PD-1 inhibitor plus chemotherapy in advanced esophageal squamous cell carcinoma. Investigators reported that pretreatment lncRNA RIME—especially when combined with PD-L1—distinguished patients with markedly different outcomes. The work positions lncRNA-based risk stratification alongside established immune markers as trial investigators look for better targeting beyond broad PD-L1 expression categories. Because the analysis is described as exploratory, the next steps for clinical translation will depend on validation in larger cohorts and clear thresholds for treatment assignment.