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The primary reason is not simply a lack of immune activation, but rather the marked spatiotemporal heterogeneity of the tumour immune microenvironment. Previous reviews have mainly focused on individual immune components, immunosuppressive mechanisms, or therapeutic approaches, with less systematic integration of distinct anatomical niches, treatment\u2010stage evolution, and their implications for precision immunotherapy selection.<\/jats:p>\n                    <jats:p>Main body: In this review, we propose a spatiotemporal immune heterogeneity framework to understand differential immunotherapy responses in OC. We first summarize the distinct immune landscapes across different anatomical niches, highlighting how anatomical niches shape immune suppression, immune exclusion and therapeutic vulnerability. We further discuss temporal remodelling of the tumour immune microenvironment during disease progression, emphasizing that immune states represent dynamic biological processes rather than fixed tumour characteristics. Based on this concept, we review biomarker\u2010guided stratification strategies. Precision therapeutic strategies are further discussed according to distinct immune ecosystems. Finally, we highlight major challenges in clinical translation, including biomarker standardization, multicentre validation and the development of artificial intelligence\u2010assisted decision systems.<\/jats:p>\n                    <jats:p>Conclusion: By linking immune ecosystem evolution, this review provides a framework for transitioning OC immunotherapy towards dynamic and precision\u2010guided clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ctm2.70836","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:07:38Z","timestamp":1789430858000},"source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal immune heterogeneity and precision immunotherapy for ovarian cancer"],"prefix":"10.1002","volume":"16","author":[{"given":"Xinfeng","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yida","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternal and Child Health Care Hospital Wuxi Medical Center Nanjing Medical University  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyue","family":"You","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Gao","sequence":"additional","affiliation":[{"name":"Suzhou Medical College Soochow University  Suzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangkun","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternal and Child Health Care Hospital Wuxi Medical Center Nanjing Medical University  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7983-8396","authenticated-orcid":false,"given":"Yan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"},{"name":"Department of Oncology Wuxi Maternal and Child Health Care Hospital Wuxi Medical Center Nanjing Medical University  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1741-0968","authenticated-orcid":false,"given":"Bing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaojie","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7014-0388","authenticated-orcid":false,"given":"Yanfang","family":"Gu","sequence":"additional","affiliation":[{"name":"Department of Oncology Wuxi Maternity and Child Health Care Hospital Women's Hospital of Jiangnan University Jiangnan University  Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3802\/jgo.2020.31.e70"},{"key":"e_1_2_13_4_1","unstructured":"Institute NC. 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