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?
Indian mangoes celebrated in Riyadh
- India is the world’s largest producer of mangoes, boasting over 1,200 local varieties and accounting for 45 percent of global production
- Saudi Arabia is a significant importer of the fruit, ensuring the availability of premium varieties for local consumers
The Embassy of India in Riyadh, in collaboration with the Agriculture and Processed Food Export Development Authority, recently organized a culinary festival titled “Indian Mango Indulgence” at Tresor Modern Indian Restaurant.
The event showcased the rich heritage and diverse flavors of Indian mangoes, celebrated through a unique menu crafted by renowned celebrity chef, Sanjay Thakur.
“This event is all about celebrating the harmony between Indian mangoes and Saudi ingredients,” the chef said. “By blending these rich flavors, we create a unique culinary experience that honors both cultures.”
Ambassador Suhel Ajaz Khan opened the event, noting the global renown of Indian mangoes.
He said Saudi Arabia is a significant importer of the fruit, ensuring the availability of premium varieties for local consumers.
The menu featured an array of dishes, including mango butter chicken and Goan mango fish curry, blending Indian culinary traditions with Saudi ingredients such as dates and Madinah mint.
A standout feature of the event was the salad corner, which introduced a fusion of mangoes and millets, aligning with the UN designation of 2023 as the “International Year of Millets.” This innovative approach not only celebrated mangoes but also promoted gluten-free, nutritious grains.
India is the world’s largest producer of mangoes, boasting over 1,200 local varieties and accounting for 45 percent of global production. The event served as a platform to showcase various regional mango varieties, including the renowned Alphonso, as well as Geographical Indication-tagged options like Fazli and Rataul.
In conjunction with this event, a week-long Indian mango festival was launched at Lulu Hypermarket, further promoting the rich diversity of Indian mangoes to the Saudi market. APEDA representatives engaged in meetings with major Saudi retail chains to explore expanding the availability of these premium products.
London calling: Saudi cafés and restaurants find footing in UK capital
- A guide to finding a taste of home on your travels
LONDON: As the number of Saudi expats and visitors in London continues to grow, it’s no surprise that Saudi-owned brands are rising in popularity in the British capital. So, if you’re planning to make the big move — or just visiting — but you’re concerned about feeling homesick, don’t worry; your favorite cafés are coming with you, making your mornings abroad feel a little more like home.
Somewhere Café
If you’ve visited Somewhere Café in the UAE or Saudi Arabia, then you’re already familiar with its unmatched ambiance, food, and décor. With its first UK outlet, the beloved café — which has joint Saudi-Emirati ownership — has brought its signature “home-away-from-home” experience, along with classic Middle Eastern flavors, to London’s premier department store: Harrods.
“Inspired by our travels, we invite you to experience a piece of our journey. Much like finding a painting and bringing it home as a memento, Somewhere celebrates the unique from everywhere. The space is elegantly well-travelled, with an eclectic touch, showcasing Middle Eastern influences through craft and curation,” co-founder Amal AlMarri told Arab News.
If you’re craving something beyond the ordinary, Somewhere Café delivers a fusion of flavors that reimagines nostalgic childhood dishes. Its most popular items include beef shawarma rice, kunafa croissant, and guacamole hummus. For lunch or dinner, you might try the crispy, golden shrimp kunafa or indulge in the rich truffle and cheese batata harra.
To complement its bold menu, the café features a warm, dimly lit interior — a cozy and inviting space to relax with friends and family. Before you leave, the dessert menu — featuring a delectable farak French toast or French coffee baklava — deserves an equal amount of attention.
Hijazi Corner
London’s first Saudi restaurant — Hijazi Corner — is a vibrant addition to the city’s dynamic culinary scene. At the helm is Chef Ayman Al-Zubaidi, who has cooked for Saudi royalty and celebrities. The inspiration behind the restaurant? His mother’s kitchen.
“When any chef starts to speak about food, they talk about their mum. Her chicken kabsa is a bit oily, a bit shiny, and looks amazing — even just talking about it now makes me hungry,” Al-Zubaidi told Arab News last year. “But even if I used the exact same ingredients and followed her method, hers would still taste better.”
Rooted in tradition, the menu features dishes typically found in Saudi homes — especially Jeddah’s historic Al-Balad district, where Al-Zubaidi grew up. Highlights include chicken seelag, slow-roasted lamb haneeth, and delicate, flaky samboosek.
In just two years, Hijazi Corner has become one of London’s most sought-after Middle Eastern restaurants — a testament to the deep longing among Saudi expats for authentic flavors from home.
Qahwah London
For those pining for the traditional, rich, aromatic flavors of Arabic coffee, Qahwah London is exactly what you need, with a wide selection of authentic qahwah options, including a tangy, spiced black coffee or the café’s signature Royal Infusion — a warming blend of cinnamon, cardamom, and ginger. Feeling hungry? Qahwah London also serves a range of traditional desserts such as baklava, kunafa, and basbousa — the perfect pairing for a steaming cup of Arabic coffee.
Guests can also book private gatherings for friends and family, or host intimate events like weddings or nikkah ceremonies. As part of its private offerings, the café provides a luxurious setting: rooms adorned with gold-plated coffee cups and an eye-catching assortment of traditional sweets — all designed to create a decadent group experience.
Diwan Kitchen
Diwan Kitchen is perfect for Saudis in the UK who are craving not only an authentic bite from home, but the feeling of being back in the Kingdom. It captures a key element of Arab culinary culture: its deeply social nature.
“We wanted to show people what traditional Saudi dining is like” Adem Nasraddin, co-founder of the restaurant, told Arab News on the restaurant’s opening night in May. “There’s a rhythm to Saudi life. A scent, a pace, a flavor. We bottled that feeling and served it on a plate.”
The menu takes diners on a journey across the Kingdom, from the Hijaz region, with its rich, tangy foul medammas — served in the center of the table with bread for sharing — to Najd, with jareesh, a hearty stew-like dish topped with fresh meat and vegetables.
Half Million
Grab a coffee and a quick bite at Half Million Café on Oxford Street, then stroll over to Hyde Park for the perfect London morning.
As in its original location in Saudi Arabia, Half Million in London is committed to delivering a “premium coffee experience.” Whether you’re in the mood for a classic breakfast tea or a vibrant red berry infusion, there’s something to satisfy every craving. And when the sun is out, their iced coffees offer the perfect refreshment. The menu — from cakes and sandwiches to freshly baked pastries — is completely halal.
If you’re after a bold, decadent brew in a sleek, stylish setting, Half Million Café is the ideal stop. With its modern cup designs and curated aesthetic, it’s a chic addition to London’s café scene.
What We Are Buying Today: ‘Lovera’ Saudi chocolate brand
Lovera is a Saudi chocolate brand with branches across the Kingdom and the GCC.
One day, while visiting a friend on short notice, I wanted to bring a gift that was both delicious and visually appealing. This is when I stumbled across Lovera on ToYou.
I chose the salted caramel bites, coated in fine Belgian chocolate and topped with crispy almonds.
The box contained three layers, about 35 pieces in total, and came in vibrant neon-orange packaging tied with a beautiful ribbon.
The chocolates were a hit; rich, smooth and perfectly balanced in flavor.
They offer a wide range of collections, including crunchy bites, truffles and seasonal assortments, but they may not suit all budgets as prices are on the higher end.
They also provide catering services for large events such as weddings, Eid gatherings and corporate parties. This includes options beyond chocolates, including tarts, eclairs, brownies and elegant finger canapes.
Lovera also has a cafe that serves a selection of cakes, hot and cold drinks, desserts, ice cream, mojitos and breakfast items. Their service can sometimes be slow and the items on the menu may not always be available.
Where We Are Going Today: Fika & Go – Swedish Restaurant in Al-Khobar
- The classic fika staple, the kanelbulle — or cinnamon bun — was the first thing I dug into (SR9, $2) alongside an iced latte (SR14) to help with the scorching summer heat
Take a Swedish break without the flight to Sweden — right in the Eastern Province.
We made the drive to Saihat to sample from the original branch of Fika & Go, which opened three years ago. The hole-in-the-wall joint is reminiscent of the coffee shops I came across on my recent trip to Stockholm, where I quickly adopted “fika” into my diet and daily itinerary.
The name of the cafe itself is a nod to the Swedish tradition of “fika.” Coined in the 19th century by scrambling the syllables of the word “kaffi,” the old Swedish spelling of coffee, “fika” began as playful slang for the drink itself.
Over the 20th century, it took on a new meaning: a moment of connection with others while savoring a light, sweet treat.
The classic fika staple, the kanelbulle — or cinnamon bun — was the first thing I dug into (SR9, $2) alongside an iced latte (SR14) to help with the scorching summer heat. It hit the spot just fine, though it was slightly different from the ones I tasted in Sweden.
We followed that with an assortment of croissants, each more satisfying than the last. We liked the new akkawi cheese croissant (SR16) and the zataar chocolate one (SR12).
The cheesecake eclair ball was definitely an easy bite, filled with gooey goodness. We also liked the mini mille-feuille, which oozed pastry cream in the right proportion.
The Saihat location offered clean and fast service, but there was zero seating and no restroom. Many delivery drivers were coming in and out for HungerStation orders. True to its name, that branch really is “fika and go” — strictly takeaway.
A year ago, the brand expanded to Alkhobar. Unlike the original, this one has indoor seating, making it more of a sit-down cafe experience.
In a region packed with cafes, Fika & Go has carved out its own identity by fusing Scandinavian rituals with Middle Eastern flavors — offering a little taste of Stockholm, with a Saudi twist.
For more details, check their Instagram @fika_and_go.
Jessica Kahawaty’s cookbook receives celebrity nod of approval
DUBAI: Lebanese Australian duo, model Jessica Kahawaty and mother Rita, have launched their own cookbook — with no less a person than Hollywood actress and producer Courteney Cox providing a cover quote.
Kahawaty and her mother are the minds behind UAE-based food delivery business Mama Rita and the book, “Mama Rita: Family recipes from the Mediterranean,” is now available for pre-order ahead of its release in September.
It is endorsed by Cox, who says it is “a must-have for anyone who is passionate about cooking and loves food as much as I do.”
Writing on Instagram on Monday, Kahawaty said: “The moment we held the Mama Rita cookbook in our hands for the very first time … after two years of pouring our hearts into it. And we’re beyond thrilled to share a special surprise on the cover — a quote from the one and only (Courteney Cox). Her iconic role as Monica in ‘Friends’ — the talented chef, perfectionist, and loving control freak — mirrors so much of the dynamic between mum and me. And her true persona is even more beautiful, warm, and generous.
“Years of love, passion, late nights and so many memories. It’s all finally coming to life just as Mama Rita turns five this September,” she added.
Kahawaty is on an entrepreneurial roll, having launched jewelry brand Kahawaty Jewels alongside her father, master jeweler Ghassan Kahawaty, in May. Based in Dubai, it continues the family’s long-standing tradition of jewelry craftsmanship.
“I grew up watching my father in his jewelry trade. I saw how happy he made people when he created these beautiful pieces,” Kahawaty told Arab News. “I’ve always wanted to continue my father’s legacy and my grandfather’s trade. I felt like this is the perfect time to launch Kahawaty Jewels in Dubai, which is a city I’ve been in for over 13 years.”
For Jessica, building the brand with her father has been a meaningful journey.
“He’s the only man I trust when it comes to diamonds and jewelry. He has an impeccable eye for detail and quality. He has the most incredible craftsmanship. I learned so much from him and launching this with my father feels like a true partnership,” she said.
