Six factors considered as potential contributors to the greater efficacy of mpJX+aPD1 on functional PanNETs were: (1) the oncolytic action of the virus itself; (2) apoptosis and suppression of tumor cell proliferation; (3) the influx of NK cells, CD8+ T cells, and other immune cells; (4) vascular changes including tumor vessel pruning, intratumoral hypoxia, necrosis, and development of HEVs and lymphatics; (5) upregulation of PD-L1; and (6) reduced tumor insulin secretion. The gene discussed is INS; the disease is neoplasm.