IGF-1 induced signaling pathways in myeloma cells (PI3K/AKT, MAPK, and NF-κB) that resulted in increased telomerase activity and upregulation of the antiapoptotic molecules, such as surviving cellular FADD-like IL-1β–converting enzyme (FLICE)-inhibitory protein (c-FLIP), X-linked inhibitor of apoptosis protein (XIAP), cellular inhibitor of apoptosis 2 (cIAP-2), and BCL-2–related protein A1 (BFL1) [99,100]. Here, XIAP is linked to plasma cell myeloma.