The promising role of engineered T lymphocytes in immunotherapy for high-grade serous ovarian carcinoma: a review of mechanisms, clinical landscape, and future strategies

High-grade serous ovarian carcinoma (HGSC) demonstrates poor prognosis with approximately 80% recurrence rates and significant chemotherapy resistance. Conventional checkpoint inhibitors show limited efficacy (10-15%), necessitating alternative immunotherapeutic approaches. Engineered T lymphocytes, particularly CAR-T and TCR-T cells, have emerged as promising strategies for HGSC. This literature review examines the promising role of engineered T lymphocytes in immunotherapy for HGSC. A comprehensive literature search was conducted across PubMed, Scopus, and Cochrane Library databases for peer-reviewed studies published between 2015 and 2025. Search terms included "engineered T lymphocytes," "CAR-T cells," "TCR-T cells," "ovarian cancer immunotherapy". CAR-T cells demonstrate promising preclinical antitumor activity in HGSC, with high-avidity T-cell clones showing robust efficacy. Engineered T lymphocytes demonstrate promising approaches across disease contexts. In high-grade serous ovarian carcinoma, Engineered T lymphocytes orchestrate tumor cell apoptosis through coordinated granzyme/perforin and Fas/FasL signaling, enabling rapid cytotoxic elimination of multiple tumor targets.