One hundred and thirty-eight unselected patients with mainly advanced gastrointestinal malignancy were randomized to receive insulin (0.11±0.05 units/kg/day) plus best available palliative support [anti-inflammatory treatment (indomethacin), prevention of anemia (recombinant erythropoietin), and specialized nutritional care (oral supplements+home parenteral nutrition)] according to individual needs. The gene discussed is INS; the disease is cancer.