About half of the patients are diagnosed with high-risk disease associated with overall survival rates below 50%, despite myeloablative therapy and differentiation therapy using retinoids.7, 8 Although many neuroblastomas respond initially well to therapy, acquired drug resistance represents a major obstacle in clinical practice.7, 8 Survivin had been previously shown to be a potential drug target in neuroblastoma.9, 10, 11, 12, 13 However, survivin had not been investigated as a therapeutic target in the acquired resistance setting in neuroblastoma prior to this study. This evidence concerns the gene BIRC5 and neuroblastoma.