IGFR inhibitors work by blocking the binding of IGFs to the IGFR, thereby inhibiting the downstream signaling pathways that promote cell proliferation and survival. This inhibition can lead to reduced tumor growth and increased apoptosis (programmed cell death) in cancer cells. The primary pathways affected by IGFR inhibitors include the PI3K/Akt and the Ras/Raf/MEK/ERK pathways, both of which are critical for cell cycle progression and survival.