IGF1 and pancreatic neoplasm: PDAC has strong invasion and migration ability because under hypoxic conditions, pancreatic cancer-associated fibroblasts (CAFs) are stimulated by hypoxia to produce insulin-like growth Factor 1 (IGF1), and IGF1/IGF1R signaling can stimulate the invasion and migration activity of PDAC cells (Hirakawa et al., 2016).