This review will first present EMT in tumor progression and discuss the mechanisms of IGF-I/IGF-IR signaling in regulating EMT programs in different epithelial tumor; secondly, we will consider the current strategies of anti-IGF-IR targeted therapy and analyze the reasons for treatment failure; Most importantly, we will extract candidate biomarkers and optional strategies to identify the right patients based on regulation mechanisms of IGF-I/IGF-IR-induced EMT progression. Here, IGF1R is linked to neoplasm.