SAN DIEGO: Dennis Lyon was a genetic train wreck. Cancer was ravaging his liver, lungs, bones and brain, and tests showed so many tumor mutations that drugs targeting one or two wouldn’t do much good. It seemed like very bad news, yet his doctors were encouraged.
The reason: People with the most messed-up genes often are the ones who do best on treatments that enlist the immune system.
“These are the patients we used to be very depressed about,” thinking they couldn’t be helped, said Dr. Razelle Kurzrock at the University of California, San Diego. “Now when we see those types of patients, we’re really excited,” because there are so many ways for the immune system to recognize the cancer cells as abnormal.
Immunotherapy is the hottest thing in cancer care. Drugs called checkpoint inhibitors can vanquish some advanced cancers by removing a chemical cloak that hides them from the immune system. Former President Jimmy Carter got one at age 91 for skin cancer that spread to his brain, and now is in remission.
But they’re expensive, have side effects, and work for only about one-quarter of patients — as few as 5 percent with colon cancer and as many as half with the skin cancer, melanoma. Sometimes the benefits are brief.
Worst of all: For a small number of unlucky folks, treatment can backfire. Their cancer grows exponentially after getting a checkpoint drug.
“We’re going to have to figure out not only who to treat with immunotherapy but who not to treat,” Kurzrock said.
Gene tests are starting to help sort that out. But for patients, the big question is “Will it work for me?“
PREDICTING WHO BENEFITS
The first step is testing for a protein called PD-L1 that’s often involved in forming that chemical cloak. Some checkpoint drugs target this or a related protein, so people with a lot of it should respond to treatment.
That was the hope when Diane Tippett showed up last October at Georgetown Lombardi Comprehensive Cancer Center with a salivary gland cancer that had spread to her liver and lungs.
“Five years ago, I probably would have thrown up my hands and given her standard chemo,” said the center’s director, Dr. Louis Weiner.
Instead, he ordered tests that showed Tippett had a PD-L1 mutation, meaning her cancer made a lot of it. He started the 49-year-old Leonardtown, Maryland, woman on a checkpoint drug, Opdivo, and told her to come back in a few months.
“Quite honestly, I didn’t know if I’d ever see her again,” he said.
Now, Tippett’s lung tumors are gone. Her liver tumor shrank 50 percent and is stable. She got married in July and says she feels great.
“I don’t feel any different than you do. I’m not tired, I’ve got all my hair,” she said. “I want more people to know about it and to ask their doctors about it,” she said of immunotherapy and the testing that led her to it.
NOT THE WHOLE STORY
That protein isn’t a very reliable predictor, though. Some people with a lot of it don’t benefit from the drugs and the opposite also is true. There are other checkpoints besides that one, too.
Researchers increasingly are focusing on something else Tippett had: a high number of flawed genes. It’s a sign that tumors have been evolving over time and are hard to treat with drugs that target a single gene. It sometimes accompanies two other DNA problems that some checkpoint drugs already are approved to treat.
Lyon, the San Diego man, had nearly two dozen different mutations after his skin cancer spread widely. In October 2015, he started on Opdivo and was in near-complete remission within two months. Recent tests showed no active cancer in his spine and lungs, and doctors think small spots in his brain and liver may be scar tissue, though they can’t know for sure. A test for tumor DNA in his blood found none.
“It would appear my cancer is all dead,” he said, and called it “nothing short of miraculous” that gene tests led to successful treatment after years of trial and error. “I’m so grateful. No one’s lucky that gets cancer but I may be in an era where there’s a way through this tunnel.”
Three-quarters of patients who are helped by checkpoint drugs have long-lasting benefits, as Lyon did, said Dr. Steven O’Day, an immunotherapy expert at Providence Saint John’s Health Center in Santa Monica, California.
“When you respond, it’s a home run in terms of long-term survival,” O’Day said. “But we still have to be better at predicting who those patients are.”
THE DARK SIDE
Others have not been so fortunate. In November, French researchers reported that 12 of 131 patients, or 9 percent, got much worse after checkpoint drugs, which seemed to speed their tumor growth.
Kurzrock checked with colleagues and quickly found more cases — a 73-year-old man with bladder cancer, a 65-year-old woman with endometrial cancer, and a 44-year-old breast cancer patient whose tumors “just exploded” in size within two months of immunotherapy.
In a report on 155 patients, she tied several gene mutations to this risk. Kurzrock has consulted for some gene-medicine makers and co-founded a company using a software program to determine best treatments for patients depending on their tumor genes.
The unfortunate cases are a reality check, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.
“We are not paying close enough attention to those people” and need to know whether they fared badly because of their treatment or for other reasons, he said.
SHOULD WE BE DOING ‘IMMUNOGRAMS’?
That’s the question Dr. Eric Topol, director of the Scripps Translational Science Institute, posed a gene medicine conference he organized in March at the suburban San Diego research center. Should there be baseline tests to map what patients’ natural defenses look like? For example, how many immune system soldiers called T cells do they have in the area of the tumor?
Max Krummel is working on a roadmap to do that. The University of California, San Francisco, scientist heads a project with $10 million from three companies that make checkpoint drugs. He is analyzing hundreds of tumor samples to see what immune system features spell success or failure.
“We’re not looking at how the immune system changes,” but for what starting point works best with the drugs, he said. “What we’re seeing is that the kinds of cells you have in a tumor predict who’s going to respond.”
Krummel, who was involved in work that led to Yervoy, the first checkpoint drug, has started a company to try to tune up one part of the immune system he thinks is key to maintaining a healthy balance.
Cancer exists because the immune system isn’t working as it should, he said, so successful immunotherapy may require “treating the immune system, not treating the tumor.”
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Marilynn Marchione can be followed on Twitter: @MMarchioneAP
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This Associated Press series was produced in partnership with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The big question: Will cancer immune therapy work for me?
The big question: Will cancer immune therapy work for me?
Where We Are Going Today: ‘Onda’ Coffee in Riyadh
- Onda offers a range of pre-packaged pastries, such as croissants in plain, cheese, and zaatar flavors
With several branches across Riyadh, Onda is a quiet, cozy coffee shop that offers a peaceful setting — ideal for studying or working.
Music, if played, is usually kept at a low volume, which helps maintain a calm atmosphere.
The menu includes a variety of hot and cold beverages, such as espresso-based drinks, iced teas, and seasonal options like hot chocolate raspberry and Arabian latte.
While the cold drinks include flavored iced teas like raspberry and peach, these are made with syrups rather than fresh fruit.
Onda also offers a range of pre-packaged pastries, such as croissants in plain, cheese, and zaatar flavors. These are reheated on-site, which is common in many Riyadh cafes, but there is no in-house bakery.
The interiors are simple and calming, with blue and white decor, comfortable seating, and plenty of charging outlets. Each location features a small bookshelf for guests to browse, adding to the relaxed vibe.
Outdoor seating — especially in the Diplomatic Quarter — is a nice touch, with some locations offering views of lively streets.
Onda is also open from 6 a.m. to 3 a.m., making it a convenient spot for both early risers and night owls.
Where We Are Going Today: Tar’fay cafe in Alkhobar
- Tar’fay hosts a treasure trove of items and every space is full of vibrant and inspiring art to help fuel your creative energy as you fuel up on caffeine
In historic northern Alkhobar — where tradition and the contemporary collide — lies a quintessential Eastern Province cafe: The eclectic and quirky world of Tar’fay.
A kaleidoscope of color and craft, the cafe is the best-kept local secret.
Everything we tried was delicious — their famous cake slice, affectionately known as “cake heart of Khobar,” features a tiny red heart in the corner and goes for SR15 ($4).
Opened in 2023, the cafe is the brainchild of a Saudi woman creative whose name it proudly carries. More than just a cafe, Tar’fay hosts a variety of artsy events; their recent calendar has been packed with workshops like junk journaling, rubber-stamp making and a teddy bear workshop.
This is the place where you would take someone from out of town to show them the aura and essence of Alkhobar.
It is also the spot in which locals park their laptops and work while sipping on some coffee or matcha.
Tar’fay hosts a treasure trove of items and every space is full of vibrant and inspiring art to help fuel your creative energy as you fuel up on caffeine. They even have fun mugs that feel like a hug for your hands.
It is an Instagram and TikTok haven but also a great spot to slow down and delve into a physical book — many of which are supplied on the coffee tables.
Tar’fay is a gathering space for creatives with a large communal table and plenty of nooks to nestle in and read, or scroll on your phone.
The cafe is open daily. Check out Tar’fay’s Instagram page for more @tarfay.sa.
Recipes for success: Chef Georges Ikhtiar offers advice and a tasty beef recipe
DUBAI: Georges Ikhtiar, head chef at Amelia Dubai, grew up in Beirut, where he remembers watching his mother cook “by instinct, without recipes or rules.”
That early exposure sparked a curiosity not just for flavors, but for the process of cooking — how ingredients transform, how timing and technique matter. This eventually led him to Lebanon’s Ecole Hôtelière.
A pivotal career moment came during his time in Peru, where he was introduced to the country’s bold, acidic and layered flavors. This now shapes his approach at Amelia, where he blends Peruvian ingredients with Japanese methods.
Here, Ikhtiar reflects on how mistakes can lead to creative breakthroughs, and gives his thoughts on simplicity in cooking.
When you started out, what was the most common mistake you made?
Like many young chefs, I believed that more was more — that adding extra ingredients or steps would somehow elevate a dish. I loved experimenting, and while that spirit of curiosity still drives me today, I’ve learned that simplicity is key. The most powerful flavors often come from restraint and letting the ingredients speak for themselves.
What’s your top tip for amateur chefs?
Taste constantly. It’s the most important tool you have. And don’t let mistakes throw you off — every error is a lesson. Some of the best ideas I’ve had started as accidents. Cooking at home should be fun, not stressful.
What’s one ingredient that can instantly improve any dish?
In Peruvian cuisine, it’s definitely lime. It brings brightness, aroma and a sense of freshness that can completely transform a dish. Just a few drops can awaken the palate and sharpen and enhance every other flavor.
What’s your go-to dish if you have to cook something quickly at home?
A simple truffle pasta. I soak the pasta to speed up the cooking time, then toss it with a creamy truffle sauce, fresh shaved truffles and parmesan. It’s rich, comforting and comes together fast, but still feels luxurious.
When you go out to eat, do you find yourself critiquing the food?
Always. It’s part of the job. I’m always observing, analyzing, and seeing what I like or don’t like. But I keep it to myself; dining out is also about experiencing what other chefs are creating.
What’s the most common mistake you notice in other restaurants?
It’s usually to do with balance or execution, like undercooked elements, seasoning that is off, or dishes that feel overcomplicated.
What’s your favorite cuisine?
I gravitate toward Japanese and Peruvian food, naturally, but I’m always curious to explore. I like to see how others approach flavor, presentation and structure. Inspiration can come from the most unexpected places.
What request or behavior by customers most annoys you?
Honestly, nothing. I believe taste is subjective and the customer is always right. We’re here to create an experience that works for them, not just for us.
What’s your favorite dish to cook?
It is a dish called Adas be Hamid, which means lentils with lemon. My grandmother used to make it when I was growing up in Beirut. It’s incredibly simple but full of flavor and warmth. Cooking it always takes me back to my roots, and I love how food has the power to do that.
What’s the most difficult dish for you to get right?
Risotto. It’s a very delicate dish that reacts to everything — temperature, timing, movement, even the humidity. You have to be fully present when making it. One misstep and the whole texture is off.
As a head chef, what are you like? Are you a disciplinarian? Or are you more laidback?
I’m direct and hands-on, but not someone who shouts. I believe in open communication, mutual respect and building trust. My team and I have worked together for a long time, so we understand each other without needing to say much. There’s a flow in the kitchen when everyone is aligned, and that’s what I strive for.
Chef Georges Ikhtiar’s hokkaido machu picchu recipe
Ingredients:
For the beef:
250g beef tenderloin
Salt and black pepper, to taste
Cooked over a robata grill (or any hot grill pan)
For the teppanyaki vegetables:
2 tbsp vegetable oil
20g Chinese cabbage, chopped
3 rainbow baby carrots, sliced
20g mange tout (snow peas)
10g shiitake mushrooms, sliced
20g baby corn, halved
1 spring onion, thickly sliced
2 tbsp soy sauce
2 tbsp kimchi sauce
2 tbsp sake sauce (optional for extra depth)
For the shiitake sauce:
300g fresh shiitake mushrooms, sliced
1L fresh cream
200ml milk
Salt and black pepper, to taste
1 small onion, chopped
1 tbsp butter
Instructions:
1. Grill the beef:
Season beef with salt and pepper. Grill on a robata grill until cooked to your liking. Let it rest before slicing.
2. Sauté the vegetables:
Heat oil in a pan. Add the vegetables and stir-fry for a few minutes.
Add soy sauce, kimchi sauce, and sake sauce (if using). Stir well and cook until just tender. Season with pepper.
3. Make the shiitake sauce:
In a saucepan, sauté onions and mushrooms in butter until soft.
Add cream, milk, salt, and pepper. Bring to a boil, reduce heat, and let simmer. Boil twice to bring out full flavor, then remove from heat.
To plate:
Slice the grilled beef.
Place the sautéed vegetables on a serving plate.
Lay the beef slices on top.
Spoon the warm shiitake sauce to the side or over the top.
Optional: If using a hot stone for serving, you can lightly reheat the meat on it just before eating for a fun finishing touch.
Where We Are Going Today: Iris Cafe in Riyadh: diverse menu, inviting atmosphere. What’s not to like?
Iris Cafe is an elegant dining destination nestled within the new Ramla Terraza complex, offering a delightful blend of food and ambiance. Located on King Fahd Road in the Sahafah district of Riyadh, this cafe and restaurant boasts a beautiful interior, complemented by both indoor and outdoor seating options. The upper floor features a stunning garden with an open seating area and a mocktail bar, perfect for enjoying a refreshing drink in a serene environment.
The menu at Iris Cafe is a culinary journey, showcasing gourmet dishes inspired by international cuisines, including Mediterranean, Japanese, and Latin American flavors. Guests can indulge in a variety of offerings, from sandwiches and pasta to vibrant salads. The drink selection is equally impressive, featuring specialty coffees and a creative array of mocktails alongside delicious desserts.
Visitors may begin with the Iris Oriental Dips, which include creamy black hummus, spicy roasted chickpeas, and special muhammara seasoned with parmesan cheese and fresh basil, all served with homemade crackers. This appetizer sets a high standard for the meal to follow and does not disappoint.
However, the chicken tacos, featuring buttermilk-fried chicken topped with Asian slaw in a soft tortilla, are less memorable. On the other hand, the crispy chicken and shrimp wontons served with sweet chili and lime sauce are a highlight and a must-try.
For the main course, you may try the glazed chicken, marinated and grilled with pomegranate sauce. The beef cheek, slow-cooked for 12 hours and served with caramelized onion cream, is absolutely delicious. This dish is a standout and sure to impress anyone looking for tender, flavorful meat.
The San Sebastian cheesecake is rich and incredibly satisfying. Overall, Iris Cafe offers a wonderful dining experience with its diverse menu and inviting atmosphere, making it a must-visit spot in Riyadh.
Recipes for success: Chef Jonathan Bouthiaux of Banyan Tree Dubai offers advice and a tasty lobster recipe
DUBAI: From Michelin-starred kitchens in France to luxury resorts across the globe, Chef Jonathan Bouthiaux has built a career defined by precision, creativity and a passion for sharing culinary stories.
His journey began in Saint-Malo, Brittany, and took an unexpected turn through charity work in Africa, where cooking became more than a skill — it became a calling. Now, as the executive chef at Banyan Tree Dubai, Bouthiaux oversees the kitchens and menus across the resort.
Here, the chef talks about learning to keep dishes simple, trusting good ingredients, and how he leads his team to create memorable dining experiences.
When you started out, what was the most common mistake you made?
Like many young chefs, I used to overcomplicate things, too many elements on a plate, trying to impress instead of letting the ingredients speak. Over time, I learned that clarity, restraint and seasonality make a stronger impact than complexity for complexity’s sake.
What’s your top tip for amateur chefs?
Master the basics. Learn how to season correctly and respect your ingredients. Do not stress. Cooking should bring joy. If you forget an ingredient, improvise. Some of the best dishes are born from happy accidents.
What ingredient can instantly improve any dish?
Acidity, like a touch of fresh lemon juice or a splash of good vinegar, can instantly elevate a dish by bringing balance, brightness and depth. It sharpens flavors and adds complexity. Another game-changer? Infused herb oils; a simple drizzle of basil or rosemary oil can completely transform a dressing or a finished plate, adding aromatic intensity and a refined, layered finish.
When you go out to eat, do you find yourself critiquing the food?
I naturally notice the details — it comes with the territory — but I always try to appreciate the overall experience.
What’s the most common issue that you find in other restaurants?
It’s not always to do with technique. Often, it’s about intent. You can sense when a dish has been prepared out of habit rather than with care. In a city like Dubai, ingredient quality and value also stand out. Today’s guests are discerning. They expect transparency and authenticity. Honest flavors and thoughtful sourcing always make a difference.
When you go out to eat, what’s your favorite cuisine?
I enjoy discovering all types of cuisine, especially when it’s something new or unexpected. That said, I am particularly drawn to Japanese and Italian food. Both are rooted in simplicity, precision and a deep respect for ingredients — values that strongly resonate with me. I also have a solid background in these cuisines, so I find myself naturally appreciating the balance, technique and cultural expression they bring to the table.
What’s your go-to dish if you have to cook something quickly at home?
A miso-glazed salmon with a side of steamed greens and sesame brown rice. It’s light, nutrient-rich and packed with umami. Plus, it comes together fast without sacrificing flavor or elegance. I always look for that sweet spot between health, simplicity, and satisfaction — something that feels good to eat and is good for you.
What customer request most frustrates you?
I’m open to adjustments where possible, but I find that excessive alterations to a dish can sometimes disrupt the flow of the dining experience. Dining should be about trusting the chef’s vision and embracing the flavors as they’re crafted. That said, our priority is always ensuring our guests feel satisfied and valued.
What’s your favorite dish to cook and why?
One of my favorites is Homard à l'Armoricaine (Lobster Armoricaine). This classic French recipe is special to me, as I’m originally from Saint-Malo, Brittany, where I first learned it at the Michelin-starred restaurant La Duchesse Anne. The dish is a true test of technique, requiring multiple steps — from preparing the lobster to creating a rich, flavorful sauce. It is a celebration of fresh lobster and bold flavors, and I enjoy the process as much as the final result. This dish always brings me back to my roots in Brittany and reminds me why I’m so passionate about cuisine.
What’s the most difficult dish for you to get right?
One dish that requires a high level of technique and precision is the pithiviers—a beautifully intricate puff pastry pie, often filled with game or foie gras, and fresh black truffle. It showcases the kind of refined execution I truly enjoy. The balance of flavors, the evenness of the puff pastry, and the perfect seal all need to come together seamlessly. It’s not just a dish, it’s a statement of culinary skill and elegance.
As a head chef, what are you like? Are you a disciplinarian? Or are you more laidback?
I oversee multiple restaurants, so it’s about building a culture. I believe in structure, consistency and leading by example. Discipline is essential, but not through fear — through clarity, respect and accountability. I focus on empowering my team, mentoring young chefs, and fostering an environment where excellence is the standard, not the exception. Consistency is key — without it, even the most creative ideas lose their value. At the end of the day, we are here to deliver memorable experiences, and that begins with a motivated, aligned team.
RECIPE: Chef Jonathan’s lobster linguini
For the Lobster Bisque:
Ingredients:
1 kg lobster shells (from raw or cooked lobster)
80 g white onion (1 small), chopped
40 g carrot (½ medium), chopped
60 g celery (1 large stalk), chopped
15 g garlic (3 cloves), crushed
50 g tomato paste (3 tbsp)
2.8 L water
2 tbsp olive oil
Salt and pepper to taste
For the pasta:
500 g linguine pasta
2 whole lobster (about 500–600 g)
2 tbsp olive oil
1 clove garlic, minced
320 g tomato sauce
160 ml lobster bisque (from above)
40 g confit or roasted cherry tomatoes
8 g fresh tarragon, chopped (plus a few leaves for garnish)
Step-by-step instructions
Make the lobster bisque (can be made ahead)
Preheat the oven to 200°C (390°F).
Place lobster shells on a baking tray and roast for 20 minutes.
In a large pot, heat olive oil, then sauté the onion, carrot, celery, and garlic for 6–8 minutes.
Add the roasted shells and tomato paste. Stir and cook for 5 minutes.
Add 2.8 L water, bring to a boil, then lower heat, cover, and simmer for 1 hour 30 minutes.
Blend the mixture using a hand blender or standard blender.
Strain through a fine sieve. Season with salt and pepper. Set aside.
Cook the lobster:
Bring a large pot of salted water to a boil. Add the lobster and poach for 5–6 minutes.
Remove, cool slightly, then crack and remove the meat. Slice into bite-sized pieces.
Heat a small pan with a knob of butter and quickly flash the lobster meat to finish.
Cook the pasta:
Boil linguine in salted water until just al dente (around 8–9 minutes).
Drain and set aside, reserving a bit of pasta water.
Assemble the dish:
In a large pan, heat 2 tbsp olive oil and sauté minced garlic until fragrant.
Add the tomato sauce and lobster bisque. Simmer for 2–3 minutes.
Add cooked pasta and toss well to coat. If needed, add a splash of pasta water.
Add chopped tarragon, cherry tomatoes, and the lobster meat. Mix gently for 1–2 minutes.
Adjust seasoning with salt and pepper.
To serve:
Plate the pasta in a warm bowl or shallow plate.
Top with lobster pieces, cherry tomatoes, and a spoon of sauce.
Garnish with fresh tarragon leaves, lobster foam (optional), and a drizzle of basil oil (optional).
