{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:48:31Z","timestamp":1788961711792,"version":"build-2803163510"},"reference-count":92,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Thrombotic complications are a common cause of morbidity and mortality in cancer patients. Factor XI (FXI) appears to play a direct role not only in thrombotic pathogenesis but also in cancer progression. This comprehensive review aims to define the pathophysiological relationships between FXI and cancer and to assess existing therapeutic opportunities targeting this factor. This review highlights how FXI is implicated in tumor growth, tumor cell adhesion and migration, inflammation, and angiogenesis. FXI inhibition has been shown to reduce the risk of thrombosis, with a potentially improved safety profile in terms of bleeding risk. Several molecules, such as asundexian and abelacimab, are in clinical trials for the prevention and treatment of venous thromboembolic events, catheter-related thrombosis, and arterial thromboembolic events in cancer patients. In conclusion, factor XI is closely linked to the pathogenesis of cancer and its thromboembolic complications. The use of FXI inhibitors emerges as a promising therapeutic strategy, offering potentially positive effects in the prevention and treatment of thromboembolic complications without significantly increasing the risk of bleeding, a limitation of conventional anticoagulants. The preliminary evidence is that further clinical trials are required and that the available data is not enough to make firm clinical recommendations.<\/jats:p>","DOI":"10.3390\/jcm14176341","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T08:43:54Z","timestamp":1757493834000},"page":"6341","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Factor XI and Cancer: Physiopathological Linkage and Clinical Perspectives"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7060-6938","authenticated-orcid":false,"given":"Alfredo","family":"Mauriello","sequence":"first","affiliation":[{"name":"Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 52, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Chiara","family":"Maratea","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 52, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5648-4552","authenticated-orcid":false,"given":"Celeste","family":"Fonderico","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 52, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4557-5401","authenticated-orcid":false,"given":"Vincenzo","family":"Quagliariello","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 52, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Maurea","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, Federico II University of Naples, Via Pansini, 5, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3704-0092","authenticated-orcid":false,"given":"Nicola","family":"Maurea","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via M. Semmola, 52, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1093\/eurheartj\/ehz405","article-title":"2019 ESC Guidelines for the Diagnosis and Management of Acute Pulmonary Embolism Developed in Collaboration with the European Respiratory Society (ERS)","volume":"41","author":"Konstantinides","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Falanga, A., Schieppati, F., and Russo, L. (2019). Pathophysiology 1. Mechanisms of Thrombosis in Cancer Patients, Springer.","DOI":"10.1007\/978-3-030-20315-3_2"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"339.e19","DOI":"10.1016\/j.amjmed.2015.10.014","article-title":"Lifetime Risk of Venous Thromboembolism in Two Cohort Studies","volume":"129","author":"Bell","year":"2016","journal-title":"Am. J. 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