Messenger RNA vaccines as adjuncts to surgical oncology: a new era in neoplasm immunotherapy and precision medicine.

Messenger RNA (mRNA) vaccines are emerging as powerful tools in oncology, extending their success from infectious diseases to cancer immunotherapy. Globally, over 13.5 billion mRNA vaccine doses have been administered, establishing a strong safety and adaptability record. In surgical oncology, where 25-40% of patients experience postoperative recurrence, mRNA vaccines offer a new avenue for durable immune surveillance. Personalized mRNA vaccines encoding tumor-specific neoantigens have shown 44% objective response rates in melanoma and a 50% reduction in recurrence when combined with checkpoint inhibitors. In pancreatic cancer, early-phase data demonstrated neoantigen-specific T-cell expansion in half of the recipients, improving relapse-free intervals. Moreover, emerging evidence links gut microbiota composition with mRNA vaccine pharmacodynamics, influencing T-cell activation by up to 35%, as demonstrated in recent pharmacomicrobiomic analyses. These findings suggest that integrating mRNA vaccines into perioperative cancer care could transform postoperative outcomes through precision immunotherapy. Collectively, this paradigm marks a new era in neoplasm immunotherapy and precision surgical oncology, bridging immune science with personalized care.