11 March 2026
Professor Robert Weinkove, Clinical Director, Malaghan Institute of Medical Research
Opinion: As a haematologist, one of the hardest conversations I have is telling someone that their blood cancer has come back, and that the treatments we usually rely on have stopped working.
A new kind of cancer treatment called ‘chimeric antigen receptor’ (CAR) T-cell therapy has transformed outcomes for some patients with blood cancers such as lymphoma or myeloma. First approved overseas in 2017, CAR T-cells are made by re-engineering a patient’s own immune cells so they can recognise and attack cancer.
The results can be remarkable. For some blood cancers, more than half of patients who had relapsed after multiple treatments went into complete remission. Many remain cancer-free years later.
CAR T-cell therapies are publicly funded in Australia, the UK and much of Europe. Yet we have none here. Even New Zealanders who can overcome the cost and logistical barriers to travel overseas for CAR T can face long delays, which may mean losing the chance to benefit at all.
Why does this gap exist?
CAR T-cells are personalised medicines and are expensive: Immune cells must be collected from patients, shipped long distances for manufacturing, then sent back for treatment. Side effects can be serious and require expert care. Until recently, New Zealand lacked the regulatory pathways, logistics and clinical experience to deliver CAR T-cell therapies safely.
Rather than accept this gap, we set out to build capability here in New Zealand. At the Malaghan Institute, working with partners across the country and internationally, we developed an experimental form of CAR T-cell therapy that aims to reduce side-effects. We didn’t stop at laboratory research. We established clinical-grade CAR T-cell manufacturing in New Zealand, tackled regulatory requirements, and completed a first-in-human clinical trial of a new CAR T-cell therapy in people with relapsed lymphoma.
Results of our phase 1 trial were encouraging. Among 30 patients treated, response rates matched those of commercial CAR T-cell therapies – but with fewer serious side effects. For patients, that could mean being treated closer to home, not spending weeks in hospital away from family.
We are now running a larger phase 2 trial across Auckland, Wellington and Christchurch, aiming to treat another 60 New Zealanders with lymphomas. But the benefits of clinical trials extend far beyond the patients who take part.
Clinical trials like this prepare the health system. They build expertise among doctors and nurses, establish safety protocols, and help regulators and funders understand what will be needed to deliver publicly funded treatment. Internationally, the centres that first delivered commercial CAR T-cell therapies were those that ran the early trials. This is how countries translate breakthrough science to standard care.
In twenty years, we will look back at today's CAR T-cells as the very beginning of a new field of immune system engineering.
Current CAR T-cell therapies are only the beginning. One of the most powerful features of CAR T-cell therapy is that it can be refined and improved over time. Researchers are already designing more sophisticated ways to reprogramme the immune system to treat other cancers, autoimmune diseases and infections. In twenty years, we will look back at today’s CAR T-cells as the very beginning of a new field of immune system engineering.
To unlock this potential, we need new ways to advance CAR T-cell therapies: flexible early-stage trials that allow treatments to improve as we learn. Combined with local manufacturing, this approach would not only offer hope to New Zealanders, but also help build a high-value biotechnology and clinical research sector. With the right support, New Zealand could become a place where the next generation of cancer treatments is not just used, but developed and produced.
I hope in the future I’ll have better answers when patients with blood cancers ask me, “What else can we try?”
Support bringing CAR T-cell therapy to Aotearoa New Zealand
Join us in making CAR T-cell therapy accessible and affordable for all New Zealanders in need.
To learn more about how you can join this ground-breaking effort please contact the Malaghan Institute's philanthropy manager An-Li Theron.
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