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Given the relatively disappointing outcomes from clinical trials directed towards modulating IGF1R signaling, there is reason to hope that an alternative approach to regulating this network of oncogenic pathways may come from regulating the ligands and their regulatory binding proteins, some of which also act through mechanisms independent of IGF1R signaling

311 It is noteworthy that elevated ROS levels will promote angiogenesis, immune evasion, and even drug resistance, which act as a supportive niche for tumor growth