INS and cancer: Therefore, in the context of malignant tumors, targeting the insulin/IGF-2/IR-A pathway primarily involves these approaches: dual intervention against both IR and IGF-1R using small molecule tyrosine kinase inhibitors (TKIs), specific targeting of IR-A function, and suppression of the ligand IGF-2, which activates both IR and IGF-1R, IR-A isoform-specific aptamers, nucleotides oligomers and selective splice-switching antisense oligonucleotides.