BIRC5 and metastatic malignant neoplasm: Cell-mediated anti-tumor responses were seen in humans when a replication competent tumor-selective adenovirus was armed with GM-CSF and injected intratumorally to patients with various metastatic cancers, and generated MHC I dependent T-cell activity against the tumor-associated antigen survivin while inducing clinical responses (tumor regression or stabilization) in 7 of 15 patients [100].