Despite that combination of IGF1R inhibitor and chemotherapy has substantially failed as first line treatment in PDAC patients with metastatic disease,48 recent evidence suggests that IGF1R inhibition leads to autophagy dependence, increasing the sensitivity to autophagy inhibitors in preclinical model of PDAC.49 In fact, it is known that IGF1R contributes to the insurgence of resistance to multiple drugs in cancer.32 Here, IGF1R is linked to metastatic neoplasm.