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The insulin-like growth factors (IGFs), IGF1 and IGF2, are peptide hormones that bind to the insulin-like growth factor 1 receptor (IGF1R) and cause intracellular signaling that ultimately results in cellular growth and proliferation. Evidence from epidemiologic and preclinical studies suggests that IGF signaling may be of importance in the pathogenesis of colorectal cancer (CRC). In recent years, agents that target the IGF1R pathway have been developed. These agents are currently under evaluation for the treatment of CRC.