José Alberto Pérez Pérez

Cancer remains one of the leading causes of mortality worldwide despite significant advances in diagnosis and treatment. The emergence of personalized messenger RNA (mRNA)-based cancer vaccines has introduced a novel therapeutic strategy capable of integrating genomic medicine, immunology, and biotechnology into precision oncology. The objective of this review was to analyze the current scientific evidence regarding the biological foundations, immunological mechanisms, clinical applications, advantages, limitations, and future perspectives of personalized mRNA cancer vaccines. A scientific method-based narrative review methodology was employed through a structured search of peer-reviewed literature indexed in PubMed, Scopus, Web of Science, ScienceDirect, SpringerLink, and other internationally recognized databases. The evidence demonstrated that personalized mRNA vaccines can encode patient-specific neoantigens, stimulate robust CD4+ and CD8+ T-cell responses, enhance dendritic-cell-mediated antigen presentation, and promote durable immunological memory. Clinical investigations have reported encouraging results in melanoma, pancreatic cancer, glioblastoma, lung cancer, and other malignancies, particularly when vaccines are combined with immune checkpoint inhibitors. The findings also revealed important advantages, including high therapeutic specificity, individualized treatment design, and rapid development capacity. However, challenges related to neoantigen selection, manufacturing costs, regulatory complexity, and healthcare infrastructure remain significant barriers to widespread implementation. From a regional perspective, countries such as Mexico, Colombia, and Ecuador are progressively expanding precision oncology capabilities, although important limitations persist regarding access to genomic technologies and advanced immunotherapies. Overall, personalized mRNA cancer vaccines represent a promising innovation with the potential to transform future cancer treatment through highly individualized and immune-based therapeutic approaches.

Cardiorenal syndrome associated with type 2 diabetes mellitus has emerged as a major global health challenge due to its increasing prevalence, complex pathophysiology, and significant impact on morbidity and mortality. The interaction between cardiovascular disease, chronic kidney disease, and metabolic dysfunction creates a bidirectional cycle of organ damage mediated by inflammation, oxidative stress, endothelial dysfunction, neurohormonal activation, and fibrosis. This review analyzes current evidence regarding the mechanisms linking diabetes with cardiovascular and renal deterioration, emphasizing the concept of the cardiorenal-metabolic continuum. A comprehensive review of contemporary literature was conducted using international scientific databases and clinical practice guidelines. The findings indicate that recent therapeutic advances, particularly sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists, have significantly improved cardiovascular and renal outcomes while reducing disease progression and hospitalization rates. Despite these advances, substantial challenges remain regarding early diagnosis, treatment accessibility, therapeutic implementation, and healthcare disparities. These challenges are especially relevant in Latin American countries, including Mexico, Colombia, and Ecuador, where the burden of diabetes and chronic kidney disease continues to rise. Current evidence supports the adoption of integrated multidisciplinary approaches focused on early detection, comprehensive risk assessment, and evidence-based therapeutic interventions. The transition from organ-centered management toward a cardiorenal-metabolic model represents a fundamental paradigm shift that may contribute to improved patient survival, preservation of organ function, and enhanced quality of life.

Cardiometabolic diseases, including obesity, type 2 diabetes mellitus, cardiovascular disease, and heart failure, represent a growing public health challenge throughout the Americas. The increasing prevalence of these conditions has generated interest in therapeutic strategies capable of simultaneously addressing multiple interconnected risk factors. This review aimed to analyze the current scientific evidence regarding the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on heart failure and cardiometabolic risk. A structured literature review based on the Scientific Method was conducted using information obtained from PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, Cochrane Library, and major international clinical guidelines. Evidence from randomized controlled trials, systematic reviews, meta-analyses, and cardiovascular outcome studies was critically evaluated and synthesized. The findings demonstrated that GLP-1 receptor agonists consistently reduce major adverse cardiovascular events, promote significant body weight reduction, improve glycemic control, and contribute to favorable cardiometabolic outcomes. Recent studies also reported improvements in symptoms, functional capacity, and quality of life among patients with obesity-related heart failure with preserved ejection fraction. Additionally, emerging evidence suggests beneficial cardiorenal effects that further support their role within the cardiorenal-metabolic continuum. The clinical relevance of these findings is particularly important for countries such as Mexico, Colombia, and Ecuador, where obesity, diabetes, and cardiovascular disease continue to increase. In conclusion, GLP-1 receptor agonists represent an important advancement in contemporary cardiometabolic medicine and may contribute significantly to integrated prevention and management strategies aimed at reducing cardiovascular and metabolic disease burden across the Americas.