Progress in the Research of Cuproptosis and Possible Targets for Gynecological Cancers

Cuproptosis is a regulated, copper-dependent form of cell death driven by mitochondrial protein lipoylation and disruption of the tricarboxylic acid (TCA) cycle. Increasing evidence in gynecologic oncology indicates that copper transport, lipoate metabolism, and respiratory-chain phosphorylation influence tumor fitness and treatment response. This review evaluates cuproptosis as a therapeutic hypothesis across gynaecologic cancers and outlines actionable targets and strategies based on this mechanism. Mechanistically, ferredoxin 1 (FDX1)-mediated lipoylation enables copper excess to precipitate TCA enzyme-dependent proteotoxic stress that is distinct from apoptosis and ferroptosis. Therapeutic concepts arising from this biology include modulation of copper flux with ionophores or chelators, inhibition of lipoic acid synthases, and disruption of mitochondrial proteostasis. Clinically, cuproptosis-related transcriptional signatures and imaging markers of mitochondrial respiration may help stratify patients for combination regimens that incorporate poly (ADP-ribose) polymerase inhibitors, anti-angiogenic agents, or immune checkpoint blockade. By synthesizing available mechanistic and translational evidence and highlighting trials-ready strategies, this review positions cuproptosis as a tractable, precision-oriented pathway for ovarian, cervical, and endometrial cancers.