治疗高级别浆液性卵巢癌（HGSOC）仍然很具挑战性。尽管在分子或T细胞水平上存在内源性免疫，HGSOC潜在地对免疫疗法具有反应性，但迄今为止针对这种疾病的免疫疗法未达到预期效果。本综述提出了一种基于上皮内T细胞存在或不存在的工作分类方法，并详细阐述了导致此类免疫表型的假说机制。这些区别可能解释了现有免疫疗法的失败，并表明，针对每种免疫表型量身定制的合理治疗方法可能会获得改善的成功。 在T细胞炎性肿瘤中，治疗可以集中在动员既存免疫力和加强内上皮肿瘤巨噬细胞微环境中T细胞的激活上。相反，在免疫排除和免疫荒漠的肿瘤中，治疗可以集中在通过重新编程巨噬细胞、基质细胞和血管上皮细胞来恢复炎症。多聚腺苷酸核苷酸酶（PARP）抑制剂、低剂量放射治疗、表观遗传学药物和抗血管生成疗法是恢复HGSOC肿瘤T细胞浸润的可用工具，可以与疫苗和重定向T细胞组合使用。©2022年Springer Nature Limited。

Treatment of high-grade serous ovarian cancer (HGSOC) remains challenging. Although HGSOC can potentially be responsive to immunotherapy owing to endogenous immunity at the molecular or T cell level, immunotherapy for this disease has fallen short of expectations to date. This Review proposes a working classification for HGSOC based on the presence or absence of intraepithelial T cells, and elaborates the putative mechanisms that give rise to such immunophenotypes. These differences might explain the failures of existing immunotherapies, and suggest that rational therapeutic approaches tailored to each immunophenotype might meet with improved success. In T cell-inflamed tumours, treatment could focus on mobilizing pre-existing immunity and strengthening the activation of T cells embedded in intraepithelial tumour myeloid niches. Conversely, in immune-excluded and immune-desert tumours, treatment could focus on restoring inflammation by reprogramming myeloid cells, stromal cells and vascular epithelial cells. Poly(ADP-ribose) polymerase (PARP) inhibitors, low-dose radiotherapy, epigenetic drugs and anti-angiogenesis therapy are among the tools available to restore T cell infiltration in HGSOC tumours and could be implemented in combination with vaccines and redirected T cells.© 2022. Springer Nature Limited.