Necrosis has been previously described as associated with the response to IGF1R inhibitors in relapsed malignant astrocytoma and squamous non-small cell lung carcinoma [34,35] and after treatment with ceritinib as an IGF1R inhibitor in a malignant neuroepithelial brain tumor [9]. The gene discussed is IGF1R; the disease is astrocytoma (excluding glioblastoma).