IGF1 and neoplasm: Similarly, biological aspects consist of hypoxia-induced increased stemness of tumor cell and MRP transporter, acidity-induced expression of multidrug transporter, cytokine, and growth factors (IL-6, IL-8, IL-11, EGF, VEGF, HGF, IGF1, TGF-β) that are released by the tumor-associated fibroblast and cytokines secreted by a tumor-associated macrophage (TAM) in M2 polarization states such as IL-6 and type I interferon.