At 31, Molly Hones was preparing to die.
She’d had a massive tumor removed from her liver the year prior, but was now learning the cancer had spread to her bones and into her blood.
Hones had a rare cancer called fibrolamellar carcinoma that was now stage 4. After being advised that most chemotherapies wouldn’t work for her, she decided she’d rather have six to 24 months without treatment, “sailing off into the sunset, enjoying my life,” she told The Post.
With a career helping children and families, Hones has long had a “deep commitment” to serving others. So knowing it might help researchers better understand the disease, she told her doctor: “I want to donate my body to science.”
If she was ready to do that, doctors asked: Why not join a trial for an experimental drug? She agreed. It’s something she now looks back on as a “moonshot.”
That was April 2024. By September of that year, five months later, she was in full remission from her cancer, and remains in remission today.
It wasn’t a miracle that helped banish the cancer — it was a cancer vaccine.
Unlike chemotherapy and radiation, which attack cancer directly but can damage healthy cells along the way, cancer vaccines teach the immune system to recognize and destroy cancer cells itself. This allows the body to fight cancer on its own, even years after treatment.
“I think that this is a moment where we really could make cancer curable by using cancer vaccines in addition to other therapies,” Kristen Dahlgren, a breast cancer survivor and external affairs officer at the Parker Institute for Cancer Immunotherapy (PICI), told The Post. “I think we’re about to change things profoundly for cancer patients.”
For the estimated 18 million Americans who are living with or have survived cancer, the kind of lasting remission Hones experienced no longer seems so far-fetched.
In August, Moderna announced that their personalized cancer vaccine for melanoma succeeded in Phase 3 trials, the final phase before moving to the FDA for approval and landing on the market.
The first of its kind, it could become available as early as next year — and is also being tested in cancers of the lung, bladder kidney, pancreas and stomach.
While it all may seem quite sudden, the cancer vaccine landscape builds on over a century of research and development, with a flurry of advancement over the last two decades.
What exactly are cancer vaccines?
When most people think of vaccines, the prevention of viruses come to mind: measles, polio, the flu.
But most research concerning cancer is focused on therapeutic vaccines, which treat existing cancer.
Both preventative and therapeutic vaccines, though, try to stimulate the immune system, creating a lasting memory so the body can continue to fight off a threat, explained Dr. Cathy Wu, a cancer vaccine researcher at the Dana-Farber Cancer Institute.
“It almost feels with cancer vaccines that all these prayers are coming to fruition.”
Molly Hones
“We’re using the vaccines to prevent relapse in those patients at high risk of relapse,” she said. “We’re … trying to prevent the cancer from coming back.”
Cancer vaccines can also be either “off-the-shelf” or personalized. Off-the-shelf vaccines target features shared across many patients, rather than being tailored to one person. That’s how we’re accustomed to vaccines working — the ones we get for the flu, for instance, are essentially the same for everyone.
Hones’s experimental vaccine was off-the-shelf. Her cancer, fibrolamellar carcinoma, almost always produces a specific abnormality across patients. This allowed scientists to develop a vaccine that would work across many patients with the same cancer.
But most cancers aren’t so cooperative. They arise as cells accumulate mutations that allow them to grow out of control. Those mutations vary from one person to the next — and keep piling up as cancer evolves. The result: No two tumors are exactly alike, and even different cells within the same tumor can carry different mutations.
That’s where personalized cancer vaccines come in. Doctors sequence the DNA of a patient’s cancer and develop a custom vaccine to teach the body to target and destroy it.
This process is still very new — and very expensive. Each vaccine costs over $100,000 to manufacture. Researchers are now working to streamline that process, with the goal of making personalized vaccines faster and more affordable to produce.
On the hunt for treatment
Cancer vaccines remain limited to clinical trials for now, leaving many patients fighting to get treatment.
Two years on from her breast cancer diagnosis, Ari Nakata had gone through chemo and radiation — and her tumor marker tests didn’t show evidence the cancer had returned.
But her back suddenly “gave out,” she told The Post, and she was concerned.
“Cancer is such a complicated, individualized, personalized disease,” the mother of two said. “What they don’t tell you is that not everything applies to everyone. So in my case, those tumor marker blood tests said that everything was fine — but it wasn’t.”
She got an MRI, which revealed that the cancer had spread to her back, bones, lungs and liver.
“It was terrifying,” she said. “[But] I try not to get overwhelmed by the big picture. I’m like, all right, what are we going to do next? What are my options?”
She investigated shark and scorpion injections, tried hormone therapy and started doing ice baths.
Nakata couldn’t find what she needed online, so she went to hospitals, meeting with doctors to learn about which clinical trials she might fit a narrow eligibility window for. Because there was no system to get her tissue samples between hospitals, she even packed up dry ice and transported them over herself.
Getting a cancer vaccine
Nakata eventually got in touch with PICI, which helped her enroll in a Washington University cancer vaccine trial.
Her vaccine needed to be delivered through electroporation, in which an electrical pulse opens a temporary hole in cell membranes so the vaccine can get in. The first time she did it, the bed she was laying on wasn’t locked down and “everyone went flying.”
“We actually started laughing because it was so ridiculous,” she recalled.
Otherwise though, “I’ve had literally no side effects from the vaccine at all, other than sore legs for a couple of days after, which you can imagine why.”
She received six vaccines, one each month. Then her doctors had good news: 24 of Nakata’s 59 targets had responded to treatment, a huge success.
“I’ve got great results from the vaccine, and I have really high hopes about what this can open up,” she said.
The future of cancer treatment
Today, Nakata feels “really healthy.” She has a few more doses scheduled and is on a targeted chemo regimen, which has been “great in terms of quality of life.” She’s also had hair growing back.
Cancer vaccines are generally used in combination with other therapies. The upcoming Moderna vaccines, for instance, are paired with an immunotherapy that prevents the cancer from hiding from immune system attacks — making it easier to kill.
Combining vaccines with treatments that attack cancer in different ways could make them more effective, and ongoing trials are helping researchers determine which combinations work best for which cancers.
Dr. Nina Bhardwaj, a cancer vaccine researcher at Mount Sinai, emphasizes how many different kinds of platforms are in the works — Moderna’s uses mRNA, while others use DNA, virus and bacteria vectors, cells and peptides as vaccine platforms.
“I’m really excited about these newer platforms … We’re seeing that these have the ability to target lots of cell [types] … I think the delivery capacity is going to be quite enormous,” she said. Many of these approaches are still in the early stages of development, with some newer technologies yet to reach human testing.
But the field is advancing at a remarkable pace. The vaccine Hones received is proceeding with promise in human trials. Her cancer mainly affects young people aged 12-30, and she thinks of the kids who might one day receive that vaccine — and get to finish school, adventure around the world and start families.
“We’re at a redefining moment of where all of this is going,” she said. “I think of all of the thoughts and prayers that we’ve had for other people with cancer in the past. Some of those prayers might not have been answered right at that time…but it almost feels with cancer vaccines that all these prayers are coming to fruition.”
