ArticleScience immunology2019
Myeloid cell-synthesized coagulation factor X dampens antitumor immunity.
Article in Science immunology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
103 citing papers in PubMed, 6 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Baseline D-dimer as a predictor of immune checkpoint inhibitor efficacy in cancer.Annals of medicine · 2026Pooled it
- Synergistic effects of anticoagulants and platelet aggregation inhibitors with immune checkpoint inhibitors in cancer therapy: a comprehensive review of preclinical and clinical evidence.Journal for immunotherapy of cancer · 2026Pooled it
- Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis.Scientific reports · 2025Pooled it
- Towards an emerging role for anticoagulants in cancer therapy: a systematic review and meta-analysis.Frontiers in oral health · 2024Pooled it
- The Net Clinical Benefit of Rivaroxaban Compared to Low-Molecular-Weight Heparin in the Treatment of Cancer-Associated Thrombosis: Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Associations Between Immune-Related Venous Thromboembolism and Efficacy of Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Efficacy and safety of low-molecular-weight heparin or rivaroxaban combined with immunotherapy and chemotherapy in the treatment of advanced nonsmall cell lung cancer: a prospective, randomized, controlled clinical study.Cancer immunology, immunotherapy : CII · 2025Trial
- The Cancer Immunotherapy Thromboembolism Assessment: A Novel Score for Predicting Thromboembolic Events in Melanoma Patients Treated With Immune Checkpoint Inhibition.International journal of cancer · 2026Article
- Integrated Bulk and Single-Cell Transcriptomics Reveals the C3-C3AR1 Axis as a Candidate Mediator of Coagulome-Immune Crosstalk in Osteosarcoma.Biomedicines · 2026Article
- New oral anticoagulants and hepatocellular carcinoma among patients with HBV, HCV, and alcoholic liver diseases: a nationwide cohort study.Hepatology international · 2026Article
- Epithelial TMPRSS2 impairs glucose homeostasis in obese mice by regulating ghrelin-GLP-1 receptor signaling pathway.JCI insight · 2026Article
- Targeting PAR-2 with a negative allosteric modulator increases tumor antigen presentation and potentiates anti-PD-1 immunotherapy.Journal for immunotherapy of cancer · 2026Article
- Protease-Activated Receptor-2 Promotes Metastasis: An Emerging Therapeutic Target.Molecular cancer research : MCR · 2026Review
- Fully Synthetic Non-Carbohydrate Heparin Mimetics-Perspectives for Therapeutic Anticoagulation and Beyond?Archiv der Pharmazie · 2026Review
- Anticoagulants beyond coagulation: a narrative review of cardiovascular effects.Cardiovascular research · 2026Review
- The unseen architects of metastasis: coagulation factors in pre-metastatic niche development.Cell communication and signaling : CCS · 2026Review
- Case Report: Upper extremity deep vein thrombosis revealing an occult invasive ductal breast carcinoma.Frontiers in cardiovascular medicine · 2026Article
- ROS-sensitive liposomal co-delivery of photosensitizer, factor Xa inhibitor, and PD-L1 blockade enhances photodynamic immunotherapy.Theranostics · 2026Article
- Emerging roles of haemostatic proteins as markers of disease progression and prognosis in breast cancer.Exploration of targeted anti-tumor therapy · 2026Review
- Bidirectional regulatory mechanisms and therapeutic prospects of tumor hypercoagulable state and immunosuppressive tumor microenvironment.Oncology reviews · 2026Review
43 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
Immune evasion in the tumor microenvironment (TME) is a crucial barrier for effective cancer therapy, and plasticity of innate immune cells may contribute to failures of targeted immunotherapies. Here, we show that rivaroxaban, a direct inhibitor of activated coagulation factor X (FX), promotes antitumor immunity by enhancing infiltration of dendritic cells and cytotoxic T cells at the tumor site. Profiling FX expression in the TME identifies monocytes and macrophages as crucial sources of extravascular FX. By generating mice with immune cells lacking the ability to produce FX, we show that myeloid cell-derived FX plays a pivotal role in promoting tumor immune evasion. In mouse models of cancer, we report that the efficacy of rivaroxaban is comparable with anti-programmed cell death ligand 1 (PD-L1) therapy and that rivaroxaban synergizes with anti-PD-L1 in improving antitumor immunity. Mechanistically, we demonstrate that FXa promotes immune evasion by signaling through protease-activated receptor 2 and that rivaroxaban specifically targets this cell-autonomous signaling pathway to reprogram tumor-associated macrophages. Collectively, our results have uncovered the importance of FX produced in the TME as a regulator of immune cell activation and suggest translational potential of direct oral anticoagulants to remove persisting roadblocks for immunotherapy and provide extravascular benefits in other diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.