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These observations have stimulated interest in antigen-directed immunotherapies, including adoptive cell therapies (chimeric antigen receptor T cell, TIL therapy), bispecific antibodies, cancer vaccines, cytokine-based agents, and antibody\u2013drug conjugates. Multiple targets, such as mesothelin, folate receptor-\u03b1, HER2, MUC16, EpCAM, and claudin-6, are currently under clinical investigation. In this review, we summarize the current landscape of immunotherapy in OC and examine the biological and clinical factors that have limited therapeutic efficacy to date. We also discuss emerging strategies aimed at overcoming resistance, including rational combinations and biomarker-driven approaches. 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