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1 Introduction Ovarian cancer (OC) is the most lethal gynecological neoplasm due to its high mortality ( Immune cells are a cluster of different cells that have differentiated from bone marrow hematopoietic stem cells ( Immunotherapy is the next generation of treatment that is rapidly developing after traditional treatments such as surgery, radiotherapy, and chemotherapy ( + tumor-infiltrating T cells with a high affinity for antigens ( 2 Overview of TIME metabolism in ovarian cancer Tumors have a complicated metabolic pattern that is a highly adaptable response to hypoxia and nutritional deficiency ( 2.1 Metabolism of ovarian cancer cells Ovarian cancer cells have a heterogeneous metabolism, which means they are able to modify their metabolic patterns in response to their microenvironment ( Figure 1A )

In solid tumors, the vascular system is incomplete due to the rapid growth of cells, so the oxygen supply in tumor tissue is insufficient, and the TME is characterized by hypoxia (Ferreira, 2010)

An increase in NAD + levels in normal/stem cells could recover part of their capabilities allowing improve in general health

doi:10.1007/s42000-019-00140-6