F10 and atrial fibrillation: However, post hoc analyses of NOAC trials with direct factor Xa inhibitors (ROCKET AF, ARISTOTLE, ENGAGE AF-TIMI) and observational data suggest greater safety and at least similar efficacy of NOACs compared to VKAs in patients with AF and active cancer, after excluding a high bleeding risk, significant drug-drug interactions, or severe renal impairment (Class IIa B recommendation in recent guidelines).