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FGFR4, a member of the FGFR family, is highly activated by the amplification of its ligand FGF19 in several solid tumors and hematologic malignancies, especially for hepatocellular carcinoma. Elevated FGFR4 and FGF19, participate in multiple processes of tumorigenesis and cancer progression, including cell proliferation, metastasis, and chemotherapy resistance. The structure of FGFR4 is distinct from the other three family members, allowing potential to develop specific targeting inhibitors. This review aims to summarize the recent advances of the FGF19-FGFR4 axis in cancer biology and specific FGFR4 inhibitors on cancer treatments.