IGF1R and adrenal cortex carcinoma: Insulin-like growth factor-1 receptor (IGF-1R) signaling is an important metabolic pathway in cancer.[1] IGF-1R inhibitors have shown promise in the clinic in several different malignancies, including Ewing's sarcoma, non-small cell lung carcinoma, and adrenocortical carcinoma.[2-5] Both anti-IGF-1R antibodies and small molecules directed against the kinase activity of IGF-1R are being assessed in clinical trials.[4, 6-13] Anti-IGF-1R antibodies down-regulate cell-surface IGF-1R, thereby preventing signaling through IGF-1R.