BIRC5 (Survivin) is a multifunctional inhibitor of apoptosis protein with dual roles in cell survival and mitotic regulation 1. Functionally, BIRC5 suppresses apoptosis by inhibiting caspases 3 and 7, while concurrently promoting cell proliferation and preventing default apoptosis induction during G2/M phase 2. As an essential component of the chr17 passenger complex (CPC), BIRC5 directs proper chromosome 17 and segregation during mitosis and cytokinesis by regulating CPC localization from centromeres to the midbody and organizing the spindle midzone 1. The protein maintains mitochondrial integrity and participates in mitotic spindle formation by serving as a physical scaffold for RAN-TPX2 delivery to microtubules 2. Clinically, BIRC5 is nearly undetectable in quiescent adult tissues but is ubiquitously overexpressed across most cancers, including hepatocellular carcinoma, pancreatic ductal adenocarcinoma, and colorectal cancer 345. This aberrant expression contributes to clonal expansion and therapeutic resistance. BIRC5 genetic polymorphisms—specifically rs9904341 and rs2071214—are associated with increased urinary cancer susceptibility, while rs17878467 is protective 6. MicroRNA-16-5p negatively regulates BIRC5 expression in colorectal cancer, suggesting potential therapeutic targeting 5. BIRC5 represents a compelling anticancer target, with emerging strategies including gene expression modulation, protein activity inhibition, and synergistic multi-target approaches showing promise in preclinical and clinical development 1.