The prognosis of ovarian cancer is poor, with an estimated five-year survival of only 40% for advanced disease, the stage at which most ovarian carcinomas are diagnosed. These poor outcomes are partly due to the lack of effective therapies for advanced disease and recurrence. Immunotherapies hold promise for many types of cancer; however, studies have shown that patients with ovarian cancer do not have strong responses to existing drugs. In a new article published in Nature, Moffitt Cancer Center researchers demonstrate why some ovarian cancer patients evolve better than others and suggest possible approaches to improve patient outcomes.