In particular, we observed that BET inhibition by (+)-JQ1 downregulated several genes of the IGF pathway including CHRDL1, GPC3, SPP2, MXRA8, GAS6, BMP4, PAPPA, and FAM20A. Insulin growth factor signaling is considered a critical factor for cancer stem cell survival and maintenance of the self-renewal phenotype32,54–56. Here, PAPPA is linked to cancer.