INS and urinary bladder carcinoma: Second, it can reduce the plasma level of insulin and downregulate Insulin Receptor Substrate-1 (IRS-1), which results in inactivation of downstream insulin-associated signaling pathways like PI3K-AKT/Protein Kinase B (PKB) and Ras-MAPK to inhibit tumor growth.[32,33] In line with this mechanism, Wang et al[34] demonstrated that human bladder cancer cells transfected with hsa-miR-96 inhibitor significantly reduced the growth of bladder cancer cells through reduction of mRNA and protein levels of IRS-1.