Natural killer cell exhaustion in ovarian cancer: from molecular suppression to therapeutic revival

Jun Ning1, Lan Yao1

  • 1Department of general gynecology II, Gynecology and Obstetrics Center, the First Hospital of Jilin University, Changchun, China.

Frontiers in Immunology
|January 22, 2026
PubMed

Insights

Ovarian cancer is lethal due to late diagnosis and an immunosuppressive tumor microenvironment (TME) that impairs Natural Killer (NK) cells. This review explores strategies to overcome NK cell dysfunction and enhance cancer immunity.

Area of Science:

  • Immunology
  • Oncology
  • Gynecologic Oncology

Background:

  • Ovarian cancer is a leading cause of cancer death, often diagnosed late.
  • The tumor microenvironment (TME) in ovarian cancer is highly immunosuppressive.
  • Natural Killer (NK) cells, crucial for innate immunity, are functionally impaired within the ovarian cancer TME.

Purpose of the Study:

  • To dissect the mechanisms of NK cell suppression in ovarian cancer.
  • To evaluate emerging immunotherapeutic strategies for ovarian cancer.
  • To identify ways to reinvigorate NK cell-mediated antitumor responses.

Main Methods:

  • Systematic review of molecular and cellular pathways.
  • Analysis of NK cell dysfunction in the ovarian cancer TME.
  • Evaluation of current and novel NK cell-based immunotherapies.

Main Results:

  • NK cell dysfunction is driven by immunosuppressive cytokines (e.g., TGF-β, MUC16), ligand shedding, inhibitory checkpoint expression (e.g., PD-1, TIGIT), and metabolic alterations.
  • Ovarian cancer's TME actively suppresses NK cell cytotoxicity.
  • Emerging immunotherapies show promise in restoring NK cell function.

Conclusions:

  • Understanding NK cell suppression mechanisms is critical for effective ovarian cancer treatment.
  • NK cell-based immunotherapies offer a promising avenue to enhance immunosurveillance and combat ovarian cancer.
  • Reinvigorating NK cells could overcome treatment resistance and improve patient outcomes.

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