Antisense targeting of CD47 enhances human cytotoxic T-cell activity and increases survival of mice bearing B16 melanoma when combined with anti-CTLA4 and tumor irradiation

Cancer Immunol Immunother. 2019 Nov;68(11):1805-1817. doi: 10.1007/s00262-019-02397-7. Epub 2019 Oct 18.


Antibodies targeting the T-cell immune checkpoint cytotoxic T-lymphocyte antigen-4 (CTLA4) enhance the effectiveness of radiotherapy for melanoma patients, but many remain resistant. To further improve response rates, we explored combining anti-CTLA4 blockade with antisense suppression of CD47, an inhibitory receptor on T cells that limit T-cell receptor signaling and killing of irradiated target cells. Human melanoma data from The Cancer Genome Atlas revealed positive correlations between CD47 mRNA expression and expression of T-cell regulators including CTLA4 and its counter receptors CD80 and CD86. Antisense suppression of CD47 on human T cells in vitro using a translational blocking morpholino (CD47 m) alone or combined with anti-CTLA4 enhanced antigen-dependent killing of irradiated melanoma cells. Correspondingly, the treatment of locally irradiated B16F10 melanomas in C57BL/6 mice using combined blockade of CD47 and CTLA4 significantly increased the survival of mice relative to either treatment alone. CD47 m alone or in combination with anti-CTLA4 increased CD3+ T-cell infiltration in irradiated tumors. Anti-CTLA4 also increased CD3+ and CD8+ T-cell infiltration as well as markers of NK cells in non-irradiated tumors. Anti-CTLA4 combined with CD47 m resulted in the greatest increase in intratumoral granzyme B, interferon-γ, and NK-cell marker mRNA expression. These data suggest that combining CTLA4 and CD47 blockade could provide a survival benefit by enhancing adaptive T- and NK-cell immunity in irradiated tumors.

Keywords: CD47; Immunotherapy; Melanoma; Phosphorodiamidate morpholino oligomer; SIRP-α; Thrombospondin-1.

MeSH terms

  • Animals
  • CD47 Antigen / antagonists & inhibitors*
  • CD47 Antigen / genetics
  • CD47 Antigen / immunology
  • CTLA-4 Antigen / antagonists & inhibitors*
  • Combined Modality Therapy
  • Humans
  • Ipilimumab / administration & dosage*
  • Lymphocytes, Tumor-Infiltrating / drug effects
  • Lymphocytes, Tumor-Infiltrating / immunology*
  • Lymphocytes, Tumor-Infiltrating / radiation effects
  • Melanoma, Experimental / immunology
  • Melanoma, Experimental / mortality*
  • Melanoma, Experimental / pathology
  • Melanoma, Experimental / therapy
  • Mice
  • Mice, Inbred C57BL
  • Radiation Dosage
  • Survival Rate
  • T-Lymphocytes, Cytotoxic / drug effects
  • T-Lymphocytes, Cytotoxic / immunology*
  • T-Lymphocytes, Cytotoxic / radiation effects
  • Tumor Cells, Cultured


  • CD47 Antigen
  • CTLA-4 Antigen
  • Ctla4 protein, mouse
  • Ipilimumab