‘People are dying’: Why this company wants to be ‘the Rocket Lab of immunotherapy’

Thursday, 15 May 2025

Dr Nathaniel Dasyam of the Malaghan Institute of Medical Research working on the organisation’s CAR T-cell therapy programme.

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 stories, and investigates what it will take to embed CAR T-cell therapy into New Zealand’s health system. This is part four. You can read part one here, part two here, and part three here.

New Zealand can become an international destination for ground-breaking cancer treatment, says a company aiming to be the “Rocket Lab of immunotherapy”.

BioOra, a biotech company partly owned by the Malaghan Institute of Medical Research, is set to spend tens of millions of dollars on a high tech facility in Christchurch, to manufacture cell therapies that have transformed the treatment of some blood cancers.

“We're working with incredible urgency and speed,” its managing director John Robson told Stuff. “There are people literally dying, waiting for this.”

CAR T-cell therapy involves the collection of a patient’s immune cells, which are then genetically modified to recognise and kill their cancer, and then infused back into the patient’s blood.

The breakthrough therapy has put some blood cancer patients with little hope into long-term remission, but isn’t available privately or publicly in New Zealand.

CAR T-cells (pink) in action against a clump of blood cancer cells (green). As the cancer cells die they turn blue. Image taken by Alfonso Schmidt and Yasmin Nouri of the Malaghan Institute of Medical Research in Wellington.

Stuff articles this week have told the stories of patients paying hundreds of thousands of dollars to receive the immunotherapy overseas.

CAR T-cell therapy is present in New Zealand, through an ongoing clinical trial by Wellington’s Malaghan Institute, for patients with relapsed and refractory B-cell non-Hodgkin lymphoma.

The institute has designed its own CAR T, and has handed over its automated manufacturing process to BioOra, a company formed in 2021 as a joint venture between Malaghan and Bridgewest Ventures, a private investment firm.

John Robson (blue suit in front row) is managing director of BioOra, a company formed in 2021 as a joint venture between the Malaghan Institute of Medical Research and Bridgewest Ventures, a private investment firm.

Robson said phase one of the clinical trial had produced strong results, with more than half of patients - who had run out of other treatments and were extremely sick - cleared of cancer within months of treatment.

There weren’t the serious neurotoxicity side effects that are reasonably common with overseas CAR T-cell therapies, he said, and that raised the prospect that patients would need much less monitoring and treatment in hospitals, reducing overall costs.

‘People are writing big cheques’

CAR T-cell therapy has revolutionised the treatment of some blood cancers - and studies are underway to test its application to other cancers.

Sixty lymphoma patients will receive the outpatient treatment in the trial’s second phase, currently underway. The hope is for more than 60% to achieve complete remission.

The trial aims to finish in July 2026. Efficacy and safety information would then be used for Medsafe approval. The next big hurdle: convincing a cash-strapped Pharmac to pay for CAR T, and Health NZ to cover its administration.

CAR T costs upwards of $1m to get privately in Australia and the US, and hundreds of thousands in China. Much of that covers the manufacturing/laboratory cost, but smaller biotech companies and not-for-profits are beginning to find cheaper methods.

Robson wouldn’t put forward an estimate, but said BioOra aimed to produce CAR T for a fraction of the cost currently charged to patients going to countries like the US and China. Those bills could include a desperation charge, he said.

David Downs, a board member of the Malaghan Institute of Medical Research, is alive because of CAR T-cell therapy.

“People are writing big cheques. But people are desperate for the therapy … the companies understand this, and they price accordingly.

“Our goal is to - and this is a stated goal between us and the Malaghan [Institute], is to provide the therapy at the lowest price point we can that is economically viable for the company.

“That has been the challenge for the last few years - can you manufacture at scale and produce the sort of price point that is on a sensible level that a group like Pharmac and New Zealand could access, without it breaking the bank.

“That is what we have been doing, and we think we can.”

Grand plans to make NZ an immunotherapy destination

BioOra is planning on spending tens of millions - raised through a looming initial public offering (IPO) - to build a new high-tech facility in Christchurch, to greatly scale up its automated manufacturing.

That could eventually make CAR T for other conditions including multiple myeloma and paediatric acute lymphoblastic leukemia, he said.

CAR T-cell manufacturing at the Malaghan Institute.

“The new design of the site in Christchurch … is optimised and is bespoke to our process. The question now is, I need to raise enough money to make it real … the more clinical results we get, the more valuable the company becomes and it becomes easier to raise money. So it’s all about timing.

“We have some pretty grand aspirations for New Zealand becoming a central, global powerhouse of immunotherapy, so that people would travel here, rather than to laboratories in China and India, for world-class treatment.

“That would underwrite significantly the overall cost for New Zealanders [in the public system].”

Australia was an obvious market, Robson said, and in South East Asia there were tens of thousands of patients who would need CAR T for non-Hodgkin lymphoma.

Attracting even 2% of that market would make BioOra a leading global manufacturer, and “the Rocket Lab of immunotherapy, or the Xero of immunotherapy, where you have people that are in awe of the business and want to be part of it,” Robson said.

When CAR T-cell therapy could be in the public system

The goal of BioOra and the Malaghan Institute is to have their CAR T-cell therapy available through the public health system by the first quarter of 2027.

That’s ambitious, Robson said, but the alternative is for New Zealanders to keep going offshore, or die early if they couldn’t afford to do so.

Aucklander Dale De Penning was told he was out of treatment options for his lymphoma, but after getting CAR T-cell therapy in Shanghai, China, he is now in complete remission.

“We're trying to build the infrastructure to support the health system, without any help from the health system.

“We are taking the risk because if we don't do it now, then patients will continue to have to travel and pay enormous amounts of money. And we'll lose agency over this therapy forever.

“Every week we get an email saying, ‘My mother, my sister, my son, my brother - what can you do? And it's heartbreaking, because we're so close.”

Malaghan clinical director Dr Robert Weinkove said the clinical trials - mostly funded by donations - had been called “enable”, as the aim was to enable CAR T-cell therapy to be used in New Zealand.

As the sponsor, Malaghan had not only developed a new CAR T-cell construct, it had designed an automated manufacturing process (now handed over to BioOra), and had worked through regulatory and on-the-ground treatment issues.

Thirteen patients had been enrolled so far in the trial’s second phase, he said, and that would pick up now patients were being treated out of Auckland, Wellington and Christchurch.

“The trial doesn’t address the need for CAR T-cell therapies for other conditions like myeloma or other types of lymphoma yet. One of the pieces of work we are doing at the Malaghan is working on other new constructs that might address some of those needs … we are hoping to have future phase 1 trials in those.”

David Downs, a Malaghan Institute board member, told Stuff that the clinical trial and BioOra manufacturing would also clear the way for pharmaceuticals to offer their own CAR T here, including for myeloma and brain cancers.

“The New Zealand health system is too hard to deal with, and the market is too small for them to invest the effort required to set up CAR T delivery.”

Downs, whose own advanced lymphoma was cured by CAR T, spends much of his time fundraising for the work, and said a lack of government support was a major obstacle.

“Charity should not be the way we innovate in the health sector.”