Emerging evidence links the growth hormone (GH)-insulin-like growth factor-1 (IGF1) endocrine axis to cancer development. While this putative correlation is of major translational relevance, most clinical and epidemiological reports to date found no causal linkage between GH therapy and enhanced cancer risk. Thus, it is generally agreed that GH therapy constitutes a safe pharmacological intervention. The present review focuses on a number of issues in the area of GH-IGF1 action in cancer development. Emphasis is given to the idea that GH and IGF1 do not conform to the definition of oncogenic factors. Specifically, these hormones, even at high pharmacological doses, are unable to induce malignant transformation. However, the GH-IGF1 axis is capable of ‘pushing’ already transformed cells through the various phases of the cell cycle. Viral and cellular oncogenes require an intact IGF1 signaling pathway in order to elicit transformation; in other words, oncogenic agents adopt the IGF1 pathway. This universal mechanism of action of oncogenes has broad implications in oncology. Our review provides an in-depth analysis of the interplay between the GH-IGF1 axis and cancer genes, including tumor suppressors p53 and BRCA1. Finally, the safety of GH therapy in both children and adults needs further long-term follow-up studies.

新兴证据将生长激素（GH）-胰岛素样生长因子1（IGF1）内分泌轴与癌症发展联系在一起。尽管这种假定的相关性与翻译的主要意义相关，但迄今为止，大多数临床和流行病学报告均未发现GH治疗与癌症风险增加之间存在因果关系。因此，通常同意GH疗法构成安全的药理干预。本综述着重于GH-IGF1在癌症发展中作用方面的许多问题。强调了GH和IGF1不符合致癌因子的定义。具体而言，这些激素即使在高药理剂量下也无法诱导恶性转化。但是，GH-IGF1轴是能够“推”的已在细胞周期的各个阶段转化细胞。病毒和细胞癌基因需要完整的IGF1信号通路才能引发转化。换句话说，致癌剂采用IGF1途径。癌基因的这种通用作用机制在肿瘤学中具有广泛的意义。我们的审查提供了GH-IGF1轴与癌症基因，包括抑癌基因p53和BRCA1之间相互作用的深入分析。最后，GH治疗儿童和成人的安全性需要进一步的长期随访研究。