The knowledge of cellular and molecular mechanisms underlying CSC characterizations is still very limited to explain the whole process of architecting the cancer bulk. CSCs in ovarian cancer (OCSCs) are a rare and elusive population which cannot be used to explain all the pathology behaviors of ovarian cancer although many markers have been identified and used in therapy such as CD133, CD47, CD44, ALDH1. Studies of epigenetic mechanisms and signal pathways may explore the concealing information behind the markers of CSCs/OCSCs, which will reveal the pathogenesis and prognosis of cancer. A novel marker identifying OCSCs may emerge in the future ideally meanwhile the current markers should be taken into account to optimize the genetic and epigenetic mechanisms underlying ovarian cancer primary formation, aggressive progression, and unanticipated relapse and metastases. The connection between immune system and ovarian cancer is not constant when synthetizing immune surveillance, immune evasion, and immune editing which can be taken advantage of for therapy. CAR-T cell adoptive cellular immunotherapy shows efficacy in some cancers when targeting CSC markers for ovarian cancer which is an optional candidate based on CAR construction method and specificity of OCSC antigen. Immunotherapies will not be isolated from traditional therapies like surgery, chemotherapy, and radiotherapy, and epigenetic drugs. Meanwhile, protection management to reduce adverse events and administration of regimens must be stringent in further research studies.


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This study was supported by grants from the National Natural Science Foundation of China (81772772 and 81302242), Jilin Province Science and Technology Funds (20150204007YY, 20140204022YY, 20150204041YY, and 20160101043JC), and Jilin Province Development and Reform Commission Funds (2016C046-2 and 2014G073).


The authors report no conflicts of interest in this work.


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