Creating Custom Cancer Vaccines

Nina Bhardwaj ’75

A photo shows cancer researcher Nina Bhardwaj '75 talking with a colleague at Mt. Sinai Hospital in New York City.

Photo by Mount Sinai Health System

Photo by Mount Sinai Health System

A personalized vaccine to fight cancer? It may sound like science fiction or wishful thinking, but it is an idea whose time may finally be coming thanks in part to the work of Nina Bhardwaj ’75, director of immunotherapy at the Tisch Cancer Institute at Mount Sinai in New York City.

The promise of a cancer vaccine has lured researchers for decades, but there have been only a few successes. The vaccines that have been developed target specific viruses known to cause cancer, such as the human papillomavirus and hepatitis B, which can trigger cancer in the cervix and liver. Most cancers, however, are not caused by viruses. Nina’s research has been with another promising kind of vaccine—a therapeutic vaccine—which primes a person’s own immune system to fight off cancer recurrence.

“Many years ago, it was not really appreciated that the immune system plays such a vital role in recognizing cancer cells,” Nina explains. Yet the past 10 years have seen a technological sea change in DNA sequencing of tumors, vaccine development, and the preparation of so-called neoantigens, fragments of protein highly tailored to specific cancer cells, which are at the heart of her research.

The concept is to introduce neoantigens into a cancer patient’s body to stimulate the immune system to attack existing tumors and prevent new ones from developing. “What we have been interested in is off-the-shelf, personalized vaccines, where we sequence a patient’s tumor, predict the novel antigens, and then formulate a [vaccine],” she says. But this process is labor intensive and extremely expensive, over $100,000 a patient. So what Nina and other researchers are searching for are more generic neoantigens common to various cancers, so that their work can reach as many patients as possible: a “personalized” vaccine that may be effective for more than one person.

In this kind of research, “many things fail,” Nina says. “For me, personally, it’s about the discovery—discovering either a new cell or a new pathway or a new mechanism—that ultimately will have some impact in the clinic. And you have to take a lot of risks to do that.”

Growing up in Kenya, she always knew she wanted to go into medicine. Both her parents, as well as a grandfather, were physicians there. While attending Wellesley, she became interested in conducting research, and after graduation she went on to earn her M.D./Ph.D. at New York University. “Being at a women’s college was very empowering,” she says. “It gave many of us the confidence to go out and do things that we might not otherwise have done.” Two younger sisters—Rochi Bhardwaj ’78 and Nisha Bhardwaj ’86—also attended Wellesley. (Sadly, Nisha passed away earlier this year; Nina dedicates her work to Nisha, who was a cancer survivor.)

Today, Nina runs a large lab with between 25 and 30 staff researchers. “We do basic science, we make vaccines in house, we have a special lab where we make our own vaccines for patients, and then we also do clinical trials, so it is literally ‘from bench to bedside,’” she says.

Nina’s next five years are already mapped out: She is in discussions with a pharmaceutical company to begin study on one of her vaccines, with two additional vaccines currently entering phase 1 and phase 2 trials. Beyond that, she is exploring several other lines of research into cancer vaccines and immune therapies. “If it were up to me, I’d just keep working forever, although I don’t think my family would want me to keep doing that,” she says. Her husband is also a physician, and the couple has two grown sons. “But when you find something that you really love doing you want to keep going as long as you can.” And in the field of cancer immunology, a few years can make all the difference in the world.

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