IGF1 and leiomyoma: Considering that the pure antiestrogen or anti-IGF-IR agents may only be partially effective in antagonizing E2-induced IGF-I/MAPK pathway activation and because other alternative pathways (EGFR) could compensate, it suggests that inhibitors of small downstream molecules, such as Src and ERKs, or transcription factors may better block these effects and could possibly serve as noninvasive adjuvant therapies for fibroids.