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doi: 10.1186/s12864-021-07951-1 203 Skerrett-ByrneDATriggNABromfieldEGDunMDBernsteinIRAndersonALet al

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For example, DTPs surviving therapy in residual disease (RD) express the alveolar-regenerative gene signatures, including HOP homeobox and insulin-like growth factor binding protein 2 (IGFBP2) for alveolar type 1 cell features, as well as aquaporin 4 (AQP4), surfactant protein B/C/D (SFTPB/C/D), Claudin 18 and forkhead box A2, NK2 homeobox 1 for alveolar type 2 cell features, indicating a therapy-induced primitive cell-state transition [57]

In most studies on IGF-1 Lr3 no adverse side effects were reported with use for 4-8 weeks (per the dosage limits in the above answer) followed by 4 weeks of non-use.