High levels of insulin in patients with hyperinsulinemia activate insulin/IGF signal transduction, which in turn activates phosphatidylinositol 3-kinase (PI3K)/Akt/mTOR and mitogen-activated protein kinase (MAPK) signaling pathways to promote cancer cell growth, survival, motility, and drug resistance [133]. The gene discussed is IGF1; the disease is hyperinsulinism.