Since the positive prognostic effect was only significant for ER-positive cancers, we undertook in vitro studies to compare whether therapeutically co-targeting IGF1R and SphK1 using the dual IGF1R/InR inhibitor OSI-906 and the SphK inhibitor SKI-II might be a viable clinical approach for ER-negative vs. ER-positive cancers. Here, ESR1 is linked to cancer.