Abstract:

Ovarian cancer is the malignancy with the highest mortality rate in the female reproductive system. Surgery combined with chemotherapy is the primary therapeutic regimen, but the disease is prone to recurrence and the development of platinum resistance. The tumor immune microenvironment plays a crucial role in its pathogenesis, immune evasion, and therapeutic resistance. The immune microenvironment of ovarian cancer is highly heterogeneous, comprising immune cells, stromal cells, and significantly heterogeneous malignant tumor cells. Different cellular subpopulations influence patient prognosis through complex regulatory mechanisms. Key functional mechanisms involve critical immune evasion pathways such as the programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) axis, as well as cytokine/exosome-mediated intercellular communication, and microenvironment-mediated therapeutic resistance. Current research techniques include single-cell RNA sequencing, spatial transcriptomics, and other multi-omics technologies combined with bioinformatics analysis. Experimental models include murine models, patient-derived xenograft models, and three-dimensional (3D) in vitro models. Therapeutic strategies targeting the tumor immune microenvironment primarily involve immune checkpoint inhibitors, adoptive cell therapy, and interventions targeting immunosuppressive cells. Combination therapies show greater potential for clinical application. Future research should focus on integrating multi-level data, developing novel multi-target therapeutic strategies, and advancing personalized treatment approaches to provide more effective therapeutic options for patients with ovarian cancer.

Key words: Ovarian neoplasms, Carcinoma, Tumor immune microenvironment, Tumor escape, Immunotherapy, Molecular targeted therapy