# A Perspective on the CD47-SIRPA Axis in High-Risk Neuroblastoma

Source: https://onco.cc/key-papers/paper-cd47-neuroblastoma-curr-oncol-2024/  
OnCo record `paper-cd47-neuroblastoma-curr-oncol-2024` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Review on CD47 in Neuroblastoma, in Current oncology (2024), one of the most cited Europe PMC records with CD47 in its title.

## Summary

Neuroblastoma is a pediatric cancer with significant clinical heterogeneity. Despite extensive efforts, it is still difficult to cure children with high-risk neuroblastoma. Immunotherapy is a promising approach to treat children with this devastating disease. We have previously reported that macrophages are important effector cells in high-risk neuroblastoma. In this perspective article, we discuss the potential function of the macrophage inhibitory receptor SIRPA in the homeostasis of tumor-associated macrophages in high-risk neuroblastoma. The ligand of SIRPA is CD47, known as a "don't eat me" signal, which is highly expressed on cancer cells compared to normal cells. CD47 is expressed on both tumor and stroma cells, whereas SIRPA expression is restricted to macrophages in high-risk neuroblastoma tissues. Notably, high SIRPA expression is associated with better disease outcome. According to the current paradigm, the interaction between CD47 on tumor cells and SIRPA on macrophages leads to the inhibition of tumor phagocytosis. However, data from recent clinical trials have called into question the use of anti-CD47 antibodies for the treatment of adult and pediatric cancers. The restricted expression of SIRPA on macrophages in many tissues argues for targeting SIRPA on macrophages rather than CD47 in CD47/SIRPA blockade therapy. Based on the data available to date, we propose that disruption of the CD47-SIRPA interaction by anti-CD47 antibody would shift the macrophage polarization status from M1 to M2, which is inferred from the 1998 study by Timms et al. In contrast, the anti-SIRPA F(ab') 2 lacking Fc binds to SIRPA on the macrophage, mimics the CD47-SIRPA interaction, and thus maintains M1 polarization. Anti-SIRPA F(ab') 2 also prevents the binding of CD47 to SIRPA, thereby blocking the "don't eat me" signal. The addition of tumor-opsonizing and macrophage-activating antibodies is expected to enhance active tumor phagocytosis.

Indexed on Europe PMC as PubMed record 38920727 (DOI 10.3390/curroncol31060243). Its title names CD47 and its text names Neuroblastoma; PubMed types it as a review (other, Review). It was matched automatically to the idea "Can MYC be drugged directly, and will patients tolerate it?" and no figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: Current oncology
- Year: 2024
- DOI: 10.3390/curroncol31060243
- Authors: Tang XX, Shimada H, Ikegaki N
- What it means: One of the most cited reviews Europe PMC returns for CD47 in Neuroblastoma, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
- Caveats: Matched by CD47 in the title and Neuroblastoma in the title or abstract of the Europe PMC record; the summary reproduces the record's abstract and no figure has been verified against the full paper.; A review summarises other studies; the primary reports it cites are the evidence.

## Sources

- Curr Oncol 2024: https://doi.org/10.3390/curroncol31060243
- PubMed: https://pubmed.ncbi.nlm.nih.gov/38920727/
- Europe PMC: https://europepmc.org/article/MED/38920727

## Connected records

- journals: [Current oncology](https://onco.cc/journals/current-oncology-mdpi/)
- ideas: [Can MYC be drugged directly, and will patients tolerate it?](https://onco.cc/ideas/idea-drugging-myc/)

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