CircVAPA could activate the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway by modulating the miR-377-3p and miR-494-3p/insulin-like growth factor 1 receptor (IGF1R) axis to accelerate small cell lung cancer progression [29]. The gene discussed is IGF1R; the disease is small cell lung carcinoma.