IGF1 and neoplasm: Indeed, PDAC growth and metastatic spreading appears torequire the activity of a number of factors expressed in the tumour stroma, such asTGF-β, IL-6, CTGF (Connective Tissue Growth Factor), midkine, IGF-1(Insulin-Like Growth Factor 1), IL-17 and others26, 27, 28, 36, 37, 38, 39, 40, 41, 42, 43, 44; moreover these in turnactivate stromal and infiltrating cells26, 27, 28, 42, 43, 44.