The evolution of vaccine strategies for colorectal cancer: from conventional approaches to the mRNA era.

Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide, with current treatment modalities frequently limited by tumor heterogeneity and immune evasion. Vaccine-based immunotherapy, particularly that utilizing messenger RNA (mRNA) technology, represents a promising innovative strategy due to its rapid development cycle, generally manageable safety profile in the short term, and potential for personalization. This review examines the limitations of traditional cancer vaccine platforms and contrasts them with the advantages offered by mRNA-based vaccines. It expounds on the various mechanisms through which mRNA vaccines target CRC, such as encoding tumor-associated antigens or tumor-specific neoantigens, delivering immune-stimulating cytokines, and modulating the immunosuppressive tumor microenvironment. An overview of recent clinical trials in the field of mRNA immunotherapy for colorectal cancer is provided. Preliminary evidence from early clinical studies indicates that these approaches exhibit a manageable safety profile and show signs of antitumor activity, showcasing significant potential for clinical application. Furthermore, we also discuss the challenges and prospects that mRNA vaccines are currently facing.