IGFBP, a novel target of lung cancer?

The insulin-like growth factor-1 receptor (IGF-1R) is a central component of lung cancer signal transduction pathways. A phase III study failed for carboplatin, paclitaxel, with or without figitumumab in first-line treating metastatic non-small cell lung cancer (NSCLC). There is an urgent need for a better understanding of signaling in IGF system. Insulin-like growth factor-binding proteins (IGFBPs) function as modulators for IGF signaling through sequestration of IGFs in serum and the extracellular fluid. IGFBPs can also act as transporters or modulators for IGF action and insulin action. IGFBPs have attracted increased attention for their lung cancer-related role in recent years. Recent studies have demonstrated the critical role of IGFBPs in risk assessment, early detection, prognosis evaluation, and drug resistance appraisal for lung cancer. These observations suggest a potential new approach to understand the pathogenesis of lung cancer, have important clinical implications, while additional investigations are necessary.