2015
DOI: 10.3389/fendo.2015.00077
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The Role of the Insulin/IGF System in Cancer: Lessons Learned from Clinical Trials and the Energy Balance-Cancer Link

Abstract: Numerous epidemiological and pre-clinical studies have demonstrated that the insulin/insulin-like growth factor (IGF) system plays a key role in the development and progression of several types of cancer. Insulin/IGF signaling, in cooperation with chronic low-grade inflammation, is also an important contributor to the cancer-promoting effects of obesity. However, clinical trials for drugs targeting different components of this system have produced largely disappointing results, possibly due to the lack of pred… Show more

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Cited by 132 publications
(130 citation statements)
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References 196 publications
(202 reference statements)
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“…Consequently, many drug development programs targeting the IGF-IR have been discontinued. Several possible explanations have been suggested for the failure of IGF-IR therapy, as reviewed in [187189]. Firstly, most past clinical trials failed to incorporate the use of predictive biomarkers for the selection of probable responders.…”
Section: Lessons Learned From Previous Clinical Trialsmentioning
confidence: 99%
See 1 more Smart Citation
“…Consequently, many drug development programs targeting the IGF-IR have been discontinued. Several possible explanations have been suggested for the failure of IGF-IR therapy, as reviewed in [187189]. Firstly, most past clinical trials failed to incorporate the use of predictive biomarkers for the selection of probable responders.…”
Section: Lessons Learned From Previous Clinical Trialsmentioning
confidence: 99%
“…To limit these adverse effects and prevent treatment failure it can therefore be hypothesized that next to lifestyle changes insulin sensitizers (e.g. metformin) should be combined with the IGF system inhibitors [187]. In addition, more efforts should be made to identify more selective targets to improve tumor cell selectivity and avoid IGF system related toxicity.…”
Section: Lessons Learned From Previous Clinical Trialsmentioning
confidence: 99%
“…This signaling pathway has been identified as a critical determinant of colorectal cancer (CRC) development 2, 3 , and many evidences showed hyperinsulinemia as determinant of CRC risk as well as possible prognostic factors 4–7 .…”
Section: Introductionmentioning
confidence: 99%
“…The Insulin Growth Factor-1 (IGF)-/Insulin-like Growth Factor-Receptor1 (IGF-1R) pathway is a key mediator of the response of tumor cells to the metabolic microenvironment and the regulation of tumor cell metabolism, proliferation, survival and angiogenesis. [1][2][3] This signaling pathway has been identified as a critical determinant of colorectal cancer (CRC) development, 2,3 and many evidences showed hyperinsulinemia as determinant of CRC risk as well as possible prognostic factor. [4][5][6][7] Insulin receptor substrate (IRS) 1 and IRS2 are scaffolding proteins regulating downstream signaling of IGF/IGF-1R.…”
mentioning
confidence: 99%
“…Insulin resistance appears to play a central role in endometrial carcinogenesis. Therefore, treatment with insulin-sensitizing agents that act through reducing insulin levels could offer a general approach to prevent the development of cancer and reduce metastasis (10,11).…”
Section: Introductionmentioning
confidence: 99%