TTI-621, a soluble SIRPαFc fusion protein that blocks CD47 and engages macrophage Fcγ receptors, increased phagocytosis of lymphoma cells in vitro by six differently polarized human macrophage subsets that represent an activation spectrum between proinflammatory (M1) and immunosuppressive (M2) states. TTI-621 also enhanced the phagocytosis of lymphoma cells by M1-like and M2-like tumor-associated macrophages freshly harvested from lymphoma xenograft mice.
Tumor-associated macrophages (TAMs) are heterogeneous and can adopt a spectrum of activation states between pro-inflammatory and pro-tumorigenic in response to the microenvironment. We have previously shown that TTI-621, a soluble SIRPalphaFc fusion protein that blocks the CD47 "do-not-eat" signal, promotes tumor cell phagocytosis by IFN-gamma-primed macrophages. To assess the impact of CD47 blockade on diverse types of macrophages that are found within the tumor microenvironment, six different polarized human macrophage subsets (M(-), M(IFN-gamma), M(IFN-gamma+LPS), M(IL-4), M(HAGG+IL-1beta), M(IL-10 + TGFbeta)) with distinct cell surface markers and cytokine profiles were generated. Blockade of CD47 using TTI-621 significantly increased phagocytosis of lymphoma cells by all macrophage subsets, with M(IFN-gamma), M(IFN-gamma+LPS) and M(IL-10 + TGFbeta) macrophages having the highest phagocytic response. TTI-621-mediated phagocytosis involves macrophage expression of both the low- and high-affinity Fcgamma receptors II (CD32) and I (CD64), respectively. Moreover, macrophages with lower phagocytic capabilities (M(-), M(IL-4), M(HAGG+IL-1beta)) could readily be re-polarized into highly phagocytic macrophages using various cytokines or TLR agonists. In line with the in vitro study, we further demonstrate that TTI-621 can trigger phagocytosis of tumor cells by diverse subsets of isolated mouse TAMs ex vivo. These data suggest that TTI-621 may be efficacious in triggering the destruction of cancer cells by a diverse population of TAMs found in vivo and support possible combination approaches to augment the activity of CD47 blockade.