• CD47 interacts with SIRPα and TSP-1 to suppress immune cell functions, enabling tumor immune evasion.
• Tumor microenvironment factors such as TNF-α, IFN-γ, HIF-1, and exosomes modulate CD47-mediated immune evasion.
• Anti-CD47 monoclonal antibodies face side effects and economic challenges, prompting exploration of alternative strategies.
• Combination therapy and deeper mechanistic insights into CD47 signaling may guide future antitumor drug development.