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. The gene discussed is BIRC5; the disease is familial pancreatic carcinoma.