INS and neoplasm: However, the following mechanisms have been proposed [7], BPs may (1) prevent tumors cells from metastasizing to the bone by decreasing bone turnover [8], (2) change the bone micro-environment by reducing growth factors such as insulin-like growth factor-1 (IGF-1) and insulin and thereby inhibit proliferation [9–12], (3) have immunomodulatory properties by activating γδ T cells [13, 14] and recruiting tumor-associated macrophages [15, 16], (4) reduce angiogenic factors [17, 18], and/or (5) kill dormant disseminated tumor cells [19, 20].