Optimization Strategies for Neither TLS: Spatial Immune Interaction Patterns in High-Grade Serous Ovarian Cancer

High-grade serous ovarian cancer (HGSOC), the most common cause of gynecological cancer death, is a fallopian tube-derived cancer that becomes invasive in the ovary and peritoneum. This progression highlights the need to decoding immune patterns at the site level for the transformation of therapies. In this work, we provide for the first time a detailed assessment of spatial and functional properties of TLSs in HGSOC-related sites. When comparing the nature of TLS in tumors of various origin, the authors found that ovarial tumours have relatively immature TLS compared with the highly organised TLS in fallopian tube and omental tumors. Alive TLS patients are demonstrated to have improved immunecell function compared to Pre-TLS and mild TLS patients, leading to growth of a new spatially derived TLS score holding powerful predictions. More examination points to some of the critical features of the tumor microenvironment as determinants of TLS formation. nMSCs stimulate B cell activity and support the establishment of TLSs, which have a positive influence on the prognosis of patients with cancer; on the other hand, CA-MSCs inhibit these processes. Thus, the present study improves knowledge of the interactions between stromal components and immune structure in HGSOC and lays the pretext for new therapeutic strategies that target the replenishment of tumor immunity and better prognosis of the disease.