Serum fibroblast growth factor 21 (FGF21), a hepatokine that regulates glucose, energy, and lipid metabolism during stress-induced diseases, is useful as a diagnostic and prognostic biomarker in patients with clear cell renal cell carcinoma (ccRCC).1

ccRCC, which is the most common renal malignant neoplasm, is considered a cell metabolic disease. Because novel biomarkers are needed to better sub-classify renal cell tumors and to reliably predict therapy response and outcome, researchers sought to evaluate circulating FGF21 as a potential diagnostic and prognostic cancer biomarker.

For the study, researchers measured the levels of circulating FGF21 in 51 human healthy controls. They observed no associations between FGF21 serum concentration and gender or age, but there was a significant association between FGF21 levels and triglyceride levels (P < .01).

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Then, researchers measured levels of circulating FGF21 in 98 patients with ccRCC, who were found to have higher levels of serum FGF21 than their healthy counterparts (P < .0001). In addition, 14 patients with chromophobe renal cancer had similar serum FGF21 levels to patients with ccRCC as compared with healthy controls (P < .0001).

By analyzing outcome data of the patients with cancer, results showed that high levels of FGF21, defined as greater than 219.57 pg/mL, were associated with worse disease-free survival; however, there was no significant association between FGF21 expression and 5-year overall survival.

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The study further demonstrated that serum FGF21 levels were decreased in 41.4% of patients who underwent successful surgery to remove the tumor.


  1. Knott ME, Minatta JN, Roulet L, et al. Circulating fibroblast growth factor 21 (FGF21) as diagnostic and prognostic biomarker in renal cancer. Poster presentation at: AACR Annual Meeting 2016; April 16-20, 2016; New Orleans, LA.