I have just attended the conference mentioned in the title of this post. My general impression is that mathematics as I understand it is being more and more excluded by on the one hand masses of data and on the other hand by reliance on computers related to machine learning, AI etc. A cynical formulation would be to say that a research project is a machine for converting masses of data into complicated brightly coloured diagrams. The use of simple logical arguments to get real insights is becoming rarer. In my opintion this is not because such things are no longer possible or useful but decause they are no longer fashionable. Conversations with other older participants of the conference indicate to me that I am not alone in this opinion. Having got rid of some complaints let me now say something about some of the talks at the conference I liked best.
The first of these is a case where there were huge amounts of data involved and very complicated coloured pictures but there were also practical results which I found very impressive. The talk was by Bernd Bodenmiller from Zurich. In this work mass spectrometry techniques were used to produce very detailed pictures of the distribution of substances in slices of tumour tissue. I was surprised by one picture which showed the distribution of a conventional platinum-based chemotherapeutic agent within a tumour. While it was uniformly distributed through certain parts of the tumour it was more or less absent from others. Apparently cancer cells can develop methods to exclude this kind of drug from certain regions and thus survive. The one theme in the talk which caught my attention most was an application of this method to ovarial cancer. This is a very deadly cancer with frequent relapses after treatment. In the work reported on imaging techniques were use to distinguish different classes of patients and relate the differences between them to the rate of relapse. Beyond this predictions could be made which drugs might benefit which patients most. Patients were subjected to a kind of dual treatment strategy which would be illegal in Germany but which is fortunately legal in Switzerland. The idea is that on the one hand therapy decisions are considered in a conventional way and this information is given to the tumour board. Independently of this an analysis is done using the advanced imaging methods and this information also goes to the tumour board. These two sets of information are combined to make therapeutic decisions. In one case this method was applied to a patient already in palliative care, predicted to live for only a few more weeks. Five years later she is still alive and well. This is just one extreme case and the total sample size of patients is small. Nevertheless the preliminary conclusion is that this method leads to an large extension of the lifetime of the patients (I think a factor of four) in comparison to conventional approaches.
The second talk I want to mention is that of Becca Asquith. I had already heard a talk by her on a similar subject a couple of years ago and I wrote about it in a previous post. It has been observed that the KIRs an individual has can affect their ability to combat various infectious and autoimmune diseases, both positively and negatively, depending on the example. This is correlated to which MHC molecules the individual has. The subject of the talk was understanding the mechanisms behind these phenomena. One conclusion is that a determining factor is the typical lifetime of T cells. So how could KIRs modulate this lifetime? Two hypotheses are compared. One of these is that NK cells carrying the KIRs kill T cells, thus reducing their average lifetimes. Experiments were described which together with modelling, can decide between these two mechanisms. I find that this project was a beautiful combination of theory and experiment, exactly as I imagine such a project should ideally be. The whole thing, in particular the logical connections were very well described in the talk. At the end I asked the speaker why NK cells should kill T cells. Could this be of benefit to the organism or is it just a kind of collateral damage? My understanding of the answer, which I find plausible, is that any mechanism which can be used by the immune system to regulate its activity will be used.
The third talk was by Andreas Reichel, head of research at the company Bayer. He started off by mentioning a possible mechanism of action of a drug which is different to those commonly seen. This is to direct a certain protein to the proteasome so that it is destroyed. He then talked about the way in which candidate drugs are identified in the pre-clinical region. He mentioned a method in which a relatively simple ODE model can be used to obtain information. It can be used to find promising candidates. It can be used to suggest good doses for trials. (Sometimes increasing the dose produces no effect of the kind desired.) It can be used to choose optimal times for taking blood samples when testing candidates. Apparently it has been possible to convince decision makers that this theoretical work is something they can really profit from. For me this is a good example of how (relatively simple) mathematics can be used to make a significant contribution to a practical task such as drug discovery. If someone wants to develop models of this kind or apply them in an intelligent way then they need to things from analysis which I teach students on a day to day basis.