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.