These findings lead us to believe that extracellular survivin may modulate, in vivo, the tumour microenvironment for the purpose of tumour evolution and these findings in part may be responsible for the observations that patients with a high expression of survivin protein display advanced disease, high-grade disease, abbreviated survival, resistance to therapy, and accelerated tumour recurrences (Andersen et al, 2007). The gene discussed is BIRC5; the disease is neoplasm.