CAR T-cell therapy

A revolutionary new approach to fighting cancer, CAR T-cell therapy has the potential to transform cancer treatment.

CAR T-cell therapy stands for Chimeric Antigen Receptor T-cell therapy. A one-off treatment, it works by redirecting a patient’s own immune cells (T-cells) in the laboratory, to directly identify and attack cancer cells. These modified T-cells are then returned to the patient where they can attack and destroy cancer cells. CAR T-cells have the potential to act as ‘living drugs’, providing long-term protection against relapse.

CAR T-cell therapy has the potential to target a range of cancers, with research and clinical trials underway worldwide. However, to date, it has been effective for treating certain blood cancers, including certain lymphomas, B-cell leukaemias, and myeloma. In Australia, the USA and parts of Europe, CAR T-cell therapies for these types of cancer are licensed for routine use.

In New Zealand, the Malaghan Institute’s CAR T-cell programme includes the country’s first CAR T-cell trial, with on-shore CAR T-cell manufacture and delivery. Our goals are to conduct cutting-edge trials of new CAR T-cell therapies, and to leverage our nationally-unique manufacturing, regulatory and clinical experience to help introduce CAR T-cell therapies as a standard of care in New Zealand. 

The Malaghan Institute, in partnership with Wellington Zhaotai Therapies, is developing and trialling a new CAR T-cell therapy in New Zealand for patients with certain types of relapsed and refractory B-cell non-Hodgkin lymphoma, who have exhausted other treatment options.

The treatment we are working on is a ‘third generation’ CAR T-cell therapy, which we hope may be at least as safe and effective, and easier to deliver, than treatments currently available elsewhere. However, because ENABLE is an ongoing early-phase trial, the safety and effectiveness of our CAR T-cell therapy has not yet been firmly established. 

Our ENABLE phase I safety trial got underway in late 2019, treating participants across the country to determine the optimal dose of the therapy. In January 2023 we treated our 21st and final patient in this dose escalation cohort. We plan to release results later in 2023.

We have now extended the trial based on the optimal dose to incorporate a series of manufacturing and clinical improvements – including automated manufacture using Cocoon technology. This will provide data critical for the design of a larger phase II trial, where the effectiveness can be assessed more robustly.

In parallel with the ENABLE clinical trial, our CAR T-cell research programme is focusing on improving the safety and effectiveness of current CAR T-cells, and expanding this cutting-edge technology to treat a wider range of cancers, including solid tumours.