IGF1 and cancer: Metformin is an anti-diabetic drug with direct action on phosphoinositide 3-kinase/serine/threonine kinase/mTor (Pi3k/Akt/mTor pathway) via Adenosine Monophosphate-Activated Protein Kinase (AMPK) suppressive activity on Mammalian Target of Rapamycin Complex 1 (mTORC1) and indirect effects on insulin secretion and insulin-like growth factor-1 (IGF-1) activity, which was also demonstrated to depict anti-cancer effects [37].