Given months to live, a businessman looked overseas for treatment. Now he’s cancer free

Wednesday, 31 December 2025

This article was first published in May 2025. It is republished for summer reading.

Increasingly, New Zealanders are flying offshore for a revolutionary cancer treatment that can put patients with only months to live into long-term remission.

In a five-part investigation, senior reporter Nicholas Jones tells some of those incredible stories, and investigates what it will take to embed CAR T-cell therapy into New Zealand’s health system. This is part one. You can read part two here, part three here, part four here and part five here.

After a family holiday to the Philippines Dale De Penning went on antibiotics for what he thought was a stomach bug.

The former managing director at Auckland-based Aspec Construction was soon doubled over in pain at his desk, and unable to complete a workday.

He persisted with a weekend in Melbourne to watch the Bledisloe Cup with some hard-drinking mates, but felt so ill he stuck to the waters and soft drinks.

“I didn’t even make it to the game - I was curled up in bed. The boys were sending me photos of my empty seat at the MCG.”

Back home, De Penning thought a massage might help. The masseuse rubbed his abdomen and exclaimed, ‘Oh, you’ve got a baby’.

“I thought, ‘What? You cheeky cow.’ Then she said, ‘Oh, another baby…oh, three babies!’

She grabbed my hand and pushed down, and I could feel these lumps.”

An ultrasound the following day revealed a mass almost the size of a soccer ball lodged between his spine and stomach, and two smaller masses by each kidney.

A biopsy confirmed De Penning had diffuse large B cell lymphoma - a cancer of the lymphatic system, which is the body’s disease and germ-fighting network and includes the lymph nodes, spleen, tonsils and bone marrow.

He spent much of September 2023 in Auckland Hospital being blasted with the first of three different kinds of chemotherapy.

That failed to shrink his tumours enough for De Penning, a father to a daughter, 22, and sons, aged 20 and 18, to qualify for a stem cell transplant.

In 10 short months he’d reached the end of the line in terms of treatment options. His specialists mentioned palliative care.

“I was like, ‘You’ve got to be kidding me - I’m only in my mid 50s, I’m feeling good, f**k, I’m not ready for that.’”

There was some hope. De Penning, 57, had already been researching a cutting-edge treatment called chimeric antigen receptor (CAR) T-cell therapy.

This involves the collection of a patient’s T cells, which are immune “killer” cells the body deploys to neutralise disease-causing pathogens, including viruses, and bacteria.

These defenders can struggle to notice cancer cells, which make them free to multiply at will.

This weakness is overcome by genetically modifying the T cells to recognise and kill the patient’s cancer, as they would any other foreign invader.

The “living drug” treatment has put thousands of patients without hope and only months to live into long-lasting remission, and represents a shift from ongoing treatments to a personalised, one-off therapy.

CAR T has been used overseas for more than a decade and is now standard of care in a number of countries, but isn’t available publicly or privately in New Zealand.

There is a local presence, however, through an ongoing clinical trial by Wellington’s Malaghan Institute of Medical Research.

Participating lymphoma patients had run out of treatment options and were very unwell. More than half of the phase 1 group were clear of cancer just three months later.

In Australia, CAR T is already publicly funded for qualifying lymphoma patients, and will soon be widened to other blood cancers.

New Zealanders, however, must go offshore and pay dearly.

It would cost De Penning $1m to be treated in Australia, but around a third of that by Shanghai SinoUnited Hospital, which he chose after a video consultation with its lead haematologist, Dr Lily Zhou, and feeling it had a more personalised approach.

He was picked up from the airport and taken to the modern hospital, where he found another Kiwi in the room next door - also named Dale.

The two Dales - who told unconvinced hospital staff their names weren’t especially common back home - had spoken on the phone previously, as part of a network of patients swapping notes on potential destinations.

Dale Kahaki, a father of two and former police officer from Hamilton, was on his second trip to Shanghai, to receive back his genetically modified immune cells.

He looked seriously sick, De Penning thought - his skin dull and no trace of the enthusiasm that had been in his voice back home.

De Penning focused on his own treatment. His blood was taken through an IV line, and funneled into a machine that separated the white blood cells. The remaining blood was returned to his body.

The isolated immune cells were frozen and sent to a laboratory, where the T-cells were genetically altered to produce new surface receptors (called CARs), which can recognise and attach to proteins on the cancer cells, enabling their destruction.

De Penning’s modified cells were replicated in bioreactors, swelling their ranks to the tens of millions.

That laboratory process took weeks, during which time De Penning underwent “bridging treatment” - radiation and a drug regime designed to tamp down his cancer, which had mutated and become more aggressive.

This began in China, continued once he flew home, and after he returned to Shanghai in late August last year.

On September 17 he was ready to receive his army of super-charged T cells. The doctor told him to expect the smell of popcorn during the 30 minute infusion, but he found it horrible and chugged water to cope.

“You could taste the smell, it was quite bizarre.”

De Penning was hit by a fever, then body and headaches that became unbearable.

“It felt like my head was in a vice. I was curled up in a ball crying like a baby.”

A weakened immune system and heightened risk of infection are other possible side effects, and for nine days De Penning was isolated in a cleanroom, his bed encased in a special tent pumped up with filtered air.

Staff and his wife, Susie, wore full, space suit-like PPE when visiting.

Bridging treatment continued in China and after he returned to New Zealand, where a scan found no sign of the cancer that had been a death sentence months earlier.

Such reversals have made the once unfashionable field of immunotherapy - leveraging the body’s own immune system to fight disease, instead of excising cancer through surgery or killing it via chemotherapy or radiation - one of the most promising in oncology.

CAR T is most successful against liquid tumours like lymphoma, but a raft of studies are underway to see if that could widen to solid tumours.

The therapy is big business. Dr Zhou and her team recently visited New Zealand, meeting with haematologists, representatives from the Malaghan Institute, past patients including De Penning, and prospective ones.

Currently, her hospital charges about $360,000-400,000, of which nearly 70% covers laboratory/manufacturing costs. (Pricing varies including by cancer type. De Penning spent about $600,000, because of the cost of his extensive bridging treatments.)

Zhou says as well as CAR T manufacturing, the treatment requires large, expensive multidisciplinary teams to closely monitor and treat patients.

However, she argues the outlay compares well to prolonged treatment regimes that require years of chemotherapy or other drugs, hospitalisations and follow up care, all of which reduce quality of life and stop people from working.

Globally, large pharmaceuticals have set high prices to cover manufacturing and the billions of dollars invested in clinical development and regulatory costs.

However, smaller biotech companies and not-for-profits are finding cheaper methods. In Spain, for instance, academic groups have delivered CAR T for a fraction of the cost, and prices are much lower in India.

Similar innovation is underway here through the ongoing Malaghan Institute trial, which uses its own custom CAR T, manufactured through a local biotech company, BioOra, formed and partly owned by the institute.

The aim is to scale up production and make a comparatively cheap, home-made and delivered CAR T-cell therapy for the public and private health systems.

Tim Edmonds, chief executive of Leukaemia & Blood Cancer NZ, says CAR T could be “a flagship example of how New Zealand modernises its approach to advanced health technologies”, but the Government must clear the way through red tape and provide funding.

“New Zealand now has the scientific expertise to deliver it, the critical challenge is whether our policymakers will move quickly enough.”

Auckland Hospital haematologist Dr Rodger Tiedemann, also an associate professor in medicine at the University of Auckland’s Leukaemia and Blood Cancer Research Unit, says the hype around CAR T is justified.

For patients with diffuse large B cell lymphoma, after CAR T about 40% will achieve remission lasting over 5 years - a point at which they are considered cured.

That’s remarkable, Tiedemann says, given their life expectancy would otherwise have been weeks or months, and a single surviving cancer cell would cause relapse within 5 years.

“Their CAR T cells probably haven’t persisted - they often dwindle down to very low levels within six months of therapy - but they have already eradicated all of the lymphoma cells.”

CAR T is not curative for other lymphoma types and cancers, he says, including multiple myeloma, but still used to often achieve years of remission.

Tiedemann met with Dr Zhou and her team during their New Zealand tour. The US and China are leaders in CAR T, he says, and it's understandable why patients opt for the cheaper prices in the latter. However, transparency is a concern.

“It’s difficult as a practitioner to recommend treatments when we don’t have the exact name of the treatment being given, the clinical trial data being published, and knowledge about its registration process. If patients are going to China they need to go with open eyes.”

De Penning recently sold out of his business, a step planned before his illness. He has lingering health effects, including a red blood count that hasn’t rebounded fully and has necessitated blood transfusions.

However, he can now walk the summit loop on Maungawhau Mount Eden, which rises at the end of his street, and has booked overseas travel with Susie - for leisure, not treatment.

This month De Penning had coffee with another blood cancer patient, out of options here and looking to China. He’s careful not to present CAR T-cell therapy as a sure-thing.

“Everyone's journey is going to be different, and it depends on what you've got and how bad it is, and a whole heap of other factors.”

He’s not quite ready to claim a happy ending himself - “I’m going to be looking over my shoulder, probably forever” - but is grateful to be alive.

“I am here, and I’ve just been out fishing this morning and we’ve caught snapper, and I’ve been out on the deck here having a couple of beers in the shade,” he says.

“It could have been so different.”