DHTKD1 and familial pancreatic carcinoma: Adenovirus modifications include (1) an RGD motif containing a peptide sequence to improve viral insertion into the target cell; (2) a survivin promoter driving E1A gene expression; and (3) loss of the regulation of viral E1B 55K RNA export and the apoptosis-restraining domain of E1B 19K.41, 42, 43 Owing to the low CAR expression levels in pancreatic cancer cells (Supplementary Figures S3a and b), the adenovirus infection efficiency was poor.