Dr Robert Weinkove is Clinical Director at the Malaghan Institute of Medical Research and is in clinical practice as a Consultant Haematologist at Wellington Blood & Cancer Centre, Capital and Coast District Health Board. His clinical and research interests are B-cell malignancies, cancer immunotherapy and haemato-oncology supportive care. He studied medicine at the University of Cambridge and Kings College London, trained in General Medicine and Haematology at Guy's and St Thomas' Hospitals in London and the Medizinische Hochschule Hannover in Germany, and completed an Immunology PhD with the University of Otago. Dr Weinkove is developing a clinical CAR-T cell programme in conjunction with Wellington Zhaotai Therapies Ltd.
Clinical Director Dr Robert Weinkove conducts research that seeks to harness the immune system to fight cancer. Inspired through his clinical work as a haemato-oncologist, he is interested in the use of modified immune cells (CAR T-cells) and of immune stimulating vaccines to treat and prevent cancers.
For certain types of blood cancer, chimeric antigen receptor (CAR) T cells have shown very high response rates in clinical trials. However, there are still significant challenges to overcome, including achieving better response rates, more durable responses, and improving the feasibility and cost of CAR T-cell therapy. In many ways, receiving CAR T-cell therapy is similar to a procedure that is already routinely used to treat blood cancers in New Zealand: autologous bone marrow transplantation. Patients undergo a procedure called leukapheresis to obtain immune system cells, and these are processed in the laboratory. Once the cells have been manufactured, the patient returns to the hospital to receive some chemotherapy, and is then given back the CAR T-cells as an infusion through the veins. Close monitoring is essential early after CAR T-cell therapy, because of specific toxicities that can arise.
In conjunction with researchers from Guangzhou, Dr Weinkove is overseeing development of a clinical trial of a new type of ‘third generation’ CAR T-cell therapy, which uniquely activates cells via a ’TLR2’ mechanism. Manufacture of the CAR T-cells for this trial will be at the Clinical Human Immunology Laboratory at the Malaghan Institute in Wellington. Dr Weinkove hopes that this will be the first in a series of clinical trials of this new and promising type of treatment, and is working closely with regulators and clinician colleagues to bring this type of therapy to New Zealand. In conjunction with this clinical trial programme, he will lead research into alternative methods of making CAR T-cells, which might help extent the usefulness of CAR T-cells to other cancers, and which might avoid the need to make a separate batch of CAR T-cells for every recipient, reducing future cost and improving feasibility substantially.
For people who have cancers that are at high risk of spreading or relapsing in future, but do not yet have widespread disease, simpler and safer treatments are needed. In conjunction with Professors Ian Herman at the Malaghan Institute and colleagues at the Ferrier Institute, Dr Weinkove studies new classes of vaccines that show potential to prevent growth or spread of cancer cells. Developed through informed ‘chemical immunology’ design, each type of vaccine may have unique characteristics that elicit strong immune responses in specific organs, or of specific types. By studying immune cells from the blood of people with cancer, Dr Weinkove hopes to inform rational development of these vaccines, and to determine how to combine these vaccines with other cancer therapies.
Di Ciaccio P, McCaughan G, Trotman J, Ho PJ, Cheah CY, Gangatharan S, Wight J, Ku M, Quach H, Gasiorowski R, Polizzotto MN, Prince HM, Mulligan S, Tam CS, Gregory G, Hapgood G, Spencer A, Dickinson M, Latimer M, Johnston A, Armytage T, Lee C, Cochrane T, Berkhahn L, Weinkove R, Doocey R, Harrison SJ, Webber N, Lee HP, Chapman S, Campbell BA, Gibbs SDJ, Hamad N (2020). Australian and New Zealand consensus statement on the management of lymphoma, chronic lymphocytic leukaemia and myeloma during the COVID-19 pandemic. Intern Med J.
Weinkove R, McQuilten ZK, Adler J, Agar MR, Blyth E, Cheng AC, Conyers R, Haeusler GM, Hardie C, Jackson C, Lane SW, Middlemiss T, Mollee P, Mulligan SP, Ritchie D, Ruka M, Solomon B, Szer J, Thursky KA, Wood EM, Worth LJ, Yong MK, Slavin MA, Teh BW (2020). Managing haematology and oncology patients during the COVID-19 pandemic: interim consensus guidance. Med J Aust. 2020
George P, Brown A, Weinkove R (2020). B-cell Prolymphocytic Leukaemia With a t(4;14) FGFR3/IGH Translocation: Response to Ibrutinib. Pathology. 52(4):491-492.
Grasso C, Field CS, Tang CW, Ferguson PM, J Compton B, Anderson RJ, Painter GF, Weinkove R, F Hermans I, Berridge MV (2020). Vaccines adjuvanted with an NKT cell agonist induce effective T-cell responses in models of CNS lymphoma. Immunotherapy.
Dasyam N, George P, Weinkove R (2020). Chimeric antigen receptor T-cell therapies: Optimising the dose. Br J Clin Pharmacol.
George P, Dasyam N, Giunti G, Mester B, Bauer E, Andrews B, Perera T, Ostapowicz T, Frampton C, Li P, Ritchie D, Bollard CM, Hermans IF, Weinkove R (2020). Third-generation anti-CD19 chimeric antigen receptor T-cells incorporating a TLR2 domain for relapsed or refractory B-cell lymphoma: a phase I clinical trial protocol (ENABLE). BMJ Open.10(2):e034629
Stanworth SJ, Killick S, McQuilten ZK, Karakantza M, Weinkove R, Smethurst H, Pankhurst LA, Hodge RL, Hopkins V, Thomas HL, Deary AJ, Callum J, Lin Y, Wood EM, Buckstein R, Bowen D; REDDS Investigators (2020). Red cell transfusion in outpatients with myelodysplastic syndromes: a feasibility and exploratory randomised trial. Br J Haematol. 189(2):279-290
Weng J, Lai P, Qin L, Lai Y, Jiang Z, Luo C, Huang X, Wu S, Shao D, Deng C, Huang L, Lu Z, Zhou M, Zeng L, Chen D, Wang Y, Chen X, Geng S, Weinkove R, Tang Z, He C, Li P, Du X (2019). Correction to: A novel generation 1928zT2 CAR T cells induce remission in extramedullary relapse of acute lymphoblastic leukemia. J Hematol Oncol. 12(1):117
Dickinson M, Weinkove R (2019). Maintaining a fit T-cell compartment: lymphoma treatment sequencing in the era of chimeric antigen receptor T-cell therapies. Intern Med J. 49(10):1338
Compton BJ, Farrand KJ, Tang CW, Osmond TL, Speir M, Authier-Hall A, Wang J, Ferguson PM, Chan STS, Anderson RJ, Cooney TR, Hayman CM, Williams GM, Brimble MA, Brooks CR, Yong LK, Metelitsa LS, Zajonc DM, Godfrey DI, Gasser O, Weinkove R, Painter GF, Hermans IF (2019) Enhancing T cell responses and tumour immunity by vaccination with peptides conjugated to a weak NKT cell agonist. Org & Biomol Chem 17(5):1225-1237
Wong J, Wood EM, Crispin P, Weinkove R, McQuilten ZK; Australasian Leukaemia and Lymphoma Group (ALLG) Supportive Care Group (2019) Managing hypogammaglobulinaemia secondary to haematological malignancies in Australia and New Zealand: a clinician survey. Intern Med J49(3):358-363
Fischer K, Al-Sawaf O, Bahlo J, Fink AM, Tandon M, Dixon M, Robrecht S, Warburton S, Humphrey K, Samoylova O, Liberati AM, Pinilla-Ibarz J, Opat S, Sivcheva L, Le Dû K, Fogliatto LM, Niemann CU, Weinkove R, Robinson S, Kipps TJ, Boettcher S, Tausch E, Humerickhouse R, Eichhorst B, Wendtner CM, Langerak AW, Kreuzer KA, Ritgen M, Goede V, Stilgenbauer S, Mobasher M, Hallek M (2019) Venetoclax and Obinutuzumab in Patients with CLL and Coexisting Conditions. N Engl J Med 380(23):2225-2236
Weinkove R, George P, Dasyam N, McLellan AD (2019) Selecting costimulatory domains for chimeric antigen receptors: functional and clinical considerations. Clin Transl Immunology 8(5):e1049
Weinkove R, Bowden E, Wood C, Campion V, Carter J, Hall R, Weatherall M, Beasley R, Young P (2019) A randomized controlled feasibility trial of paracetamol during febrile neutropenia in hemato-oncology patients. Leukemia & Lymphoma 1-8 60(6):1540-1547
Wheeler M, White G, Brockie S, Dickson M, Weinkove R (2018) Flow Cytometric Analysis of Mechanically Disaggregated Bone Marrow Trephine Biopsies. Cytometry B Clin Cytom94(6):935-940
Weng J, Peilong L, Le Q, Yunxin L, Zhiwu J, Chenwei L, Xin H, Suijin W, Shao D, Chengxin D, Lisi H, Zesheng L, Maohua Z, Lingji Z, Dongmei C, Yulian W, Xiaomei C, Suxia G, Weinkove R, Zhaoyang T, Chang H, Peng L, Xin D (2018) A novel generation 1928zT2 CAR T cells induce remission in extramedullary relapse of acute lymphoblastic leukemia. J Hemat Oncol 11(1):25
Gasser O, Sharples KJ, barrow C, Williams GM, Bauer E, Wood CE, Mester B, Dzhelali M, Caygill G, Jones J, Haman CM, Hinder VA, Macapagal J, McCuster M, Weinkove R, Painter GF, Brimble MA, Findlay MP, Dunbar PR, Hermans IF (2018) A phase I vaccination study with dendritic cells loaded with NY-ESO-1 & a-galactosylceramide: induction of polyfunctional T cells in high risk melanoma patients.Cancer Immunol Immunother 67(2):285-298
Speir M, Authier-Hall A, Brooks CR, Farrand KJ, Compton BJ, Anderson RJ, Heiser A, Osmond TL, Tang CW, Berzofsky JA, Terabe M, Painter GF, Hermans IF, Weinkove R (2017) Glycolipid-peptide conjugate vaccines enhance CD8+ T cell responses against human viral proteins. Scientific Reports7:14273
Lucas N, Humble M, Sim D, Balm M, Carter JM and Weinkove R (2017) Temporal changes in neutropenic blood culture isolates: and disease associations: a single centre series of 1139 episodes. Int Med J 47(8):962-965
Speir, M., Hermans, I.F. and Weinkove, R. (2017) Engaging natural killer T cells as 'universal helpers' for vaccination. Drugs
Collings S, Thompson O, Hirst E, Goossens L, George A, Weinkove R (2016) Non-Invasive Detection of Anaemia Using Digital Photographs of the Conjunctiva. PLoS One