Advances in adoptive cell therapy for ovarian cancer

Ovarian cancer remains the most lethal gynecological malignancy worldwide, with late-stage diagnosis, high recurrence rates, and chemoresistance posing persistent clinical challenges. Adoptive cell therapy (ACT), a rapidly advancing immunotherapeutic strategy, offers promising efficacy with low systemic toxicity and has emerged as a compelling option to address these limitations. This review provides a comprehensive overview of ACT modalities—including tumor-infiltrating lymphocytes (TILs), chimeric antigen receptor T cells (CAR-T), natural killer (NK) cells, and other emerging cellular therapies such as TCR-T, cytokine-induced killer (CIK) cells, and γδ T cells—in the context of ovarian cancer. We highlight the mechanistic underpinnings of ACT, the immunosuppressive features of the ovarian tumor microenvironment, and cutting-edge advances in combinatorial regimens, genetic engineering, and cell design aimed at overcoming therapeutic resistance. In particular, we discuss antigen specificity, tumor immune evasion, and stromal barriers, and summarize current clinical trial progress, efficacy outcomes, and translational barriers. Together, these insights underscore the transformative potential of ACT in ovarian cancer and outline future directions for personalized and scalable immunotherapies.