In particular, we revealed that both sirt1 pharmacological inhibition (sirtinol) and gene silencing reduce proliferation of H295R and SW13 adrenocortical cancer cells by interfering with E2/ERα and IGF1R pathways through the inhibition of several proteins, such as ERα, CCND1 and IGF1R (Figure 6) and activating apoptosis. This evidence concerns the gene ESR1 and adrenal cortex carcinoma.