Unlike other malignancies, ovarian cancer (OC) creates a complex tumor microenvironment with distinctive peritoneal ascites consisting of a mixture of several immunosuppressive cells which impair the ability of the patient's immune system to fight the disease. The poor survival rates observed in advanced stage OC patients and the lack of effective conventional therapeutic options have been attributed in large part to the immature dendritic cells (DCs), IL-10 secreting regulatory T cells, tumor-associated macrophages, myeloid-derived suppressor cells, and cancer stem cells that secrete inhibitory cytokines. This review highlights the critical role played by the intraperitoneal presence of IL-10 in the generation of an immunosuppressive tumor microenvironment. Further, the effect of antibody neutralization of IL-10 on the efficacy of DC and chimeric antigen receptor T-cell vaccines will be discussed. Moreover, we will review the influence of IL-10 in the promotion of cancer stemness in concert with the NF-κB signaling pathway with regard to OC progression. Finally, understanding the role of IL-10 and its crosstalk with various cells in the ascitic fluid may contribute to the development of novel immunotherapeutic approaches with the potential to kill drug-resistant OC cells while minimizing toxic side effects.
Keywords: CD4+ T cells; CD8+ cytotoxic T cells; Cancer stem cells; Chemokines; Chimeric antigen receptor T cells; Cytokines; Dendritic cells; Epithelial-to-mesenchymal transition; Immunosurveillance; Immunotherapy; Interferon-γ; Interleukin-10; Interleukin-12; Interleukins; Janus kinase-signal transducer and activator of transcription 3 pathway; Mesothelin; Nuclear factor-κB; Ovarian cancer; Regulatory T cells; Transforming growth factor -β; Tumor microenvironment.