卵巢癌的特点是分子、细胞和解剖水平（空间和时间）的异质性。这种异质性影响对手术和/或全身治疗的反应，并且还促进固有的和获得性的耐药性。因此，这种肿瘤类型通常具有侵袭性并且常常致命。卵巢癌不是单一的疾病实体，由多种亚型组成，每种亚型都有独特的复杂分子结构，在进展和治疗过程中会发生变化。肿瘤微环境中癌症和基质细胞的相互作用进一步影响疾病的演变和对治疗的反应。在过去的几十年中，研究人员已经描述了卵巢癌的细胞、分子、微环境和免疫异质性。传统的治疗方法将卵巢癌视为一个单一的实体。随着对异质性的日益认识，以及人们认识到提供无效的治疗可能会延迟有效的个性化方法的开发，并可能改变肿瘤的分子和细胞特征，这可能会导致对后续治疗的额外抵抗，这种情况正在慢慢发生变化。在这篇综述中，我们讨论了卵巢癌的异质性，概述了这种恶性肿瘤当前的治疗前景，并强调了开发中潜在有效的治疗策略。© 2023。Springer Nature Limited。

Ovarian carcinoma is characterized by heterogeneity at the molecular, cellular and anatomical levels, both spatially and temporally. This heterogeneity affects response to surgery and/or systemic therapy, and also facilitates inherent and acquired drug resistance. As a consequence, this tumour type is often aggressive and frequently lethal. Ovarian carcinoma is not a single disease entity and comprises various subtypes, each with distinct complex molecular landscapes that change during progression and therapy. The interactions of cancer and stromal cells within the tumour microenvironment further affects disease evolution and response to therapy. In past decades, researchers have characterized the cellular, molecular, microenvironmental and immunological heterogeneity of ovarian carcinoma. Traditional treatment approaches have considered ovarian carcinoma as a single entity. This landscape is slowly changing with the increasing appreciation of heterogeneity and the recognition that delivering ineffective therapies can delay the development of effective personalized approaches as well as potentially change the molecular and cellular characteristics of the tumour, which might lead to additional resistance to subsequent therapy. In this Review we discuss the heterogeneity of ovarian carcinoma, outline the current treatment landscape for this malignancy and highlight potentially effective therapeutic strategies in development.© 2023. Springer Nature Limited.