Advances in ovarian cancer: biological insights, therapeutic innovations, and future perspectives

This is the authors' abstract. We don't add key points for this paper.

Ovarian cancer (OC) remains a highly lethal gynecologic malignancy characterized by substantial molecular heterogeneity and diagnostic challenges. Although many reviews examine specific aspects of OC biology or treatment, few attempt to connect recent findings into a broader and coherent picture. This review provides an integrated and forward-looking synthesis of emerging mechanisms and therapeutic trends in OC, understanding OC progression and therapeutic resistance. Unique contributions of this review include providing a unified interpretation of emerging multi-omics evidence that reshapes the biological understanding of individual OC histotypes, delineating key metabolic dependencies such as glutamine addiction, aberrant lipid remodeling, glycolytic plasticity and purine pathway rewiring as potential therapeutic entry points, and elucidating how ascites-driven immune dysfunction remodels antitumor immunity to ultimately influence the effectiveness of cancer vaccines, immune checkpoint blockade and adoptive cell transfer therapies. Additionally, the review articulates underexplored therapeutic intersections, including nanotechnology-enhanced immunotherapy, gene-editing nanocarriers, and microbiome-mediated modulation of drug sensitivity and immune activation. By integrating these diverse yet interconnected domains, this review proposes updated conceptual models and cross-therapeutic strategies aimed at overcoming chemoresistance and advancing precision, personalized treatment paradigms in OC.