Immunotherapy for gynecological tumors: From mechanism to clinical practice

ABSTRACT: Gynecological tumors are a group of prevalent and highly lethal malignancies affecting the female reproductive system. The immunosuppressive tumor microenvironment, characterized by immune cell dysfunction and inhibitory cytokine dysregulation, plays a pivotal role in tumor initiation, progression, and resistance to conventional therapies. Although standard treatments-including surgery, radiotherapy, and chemotherapy-remain the mainstay for early-stage disease, they often fail to manage advanced, recurrent, or drug-resistant tumors. In recent years, immunotherapy has emerged as a transformative approach in cancer treatment, offering new hope for patients with gynecological malignancies. Notably, immune checkpoint inhibitors, adoptive cell therapy, and cancer therapeutic vaccines have exhibited encouraging efficacy across several clinical trials. This review systematically summarizes recent advances in immunotherapy for major gynecological cancers, including cervical cancer, endometrial cancer, and ovarian cancer. We focus on the immunological landscape of these tumors, the underlying mechanisms of immune-based therapies, key clinical findings, and current challenges. In addition, we highlight future research directions and explore prospects for personalized immunotherapy, aiming to provide both theoretical insight and practical guidance for clinical translation.