## Cytokine storms during CAR T-cell therapy for lymphoblastic leukemia

November 19, 2015 13 Comments

For most of the last 70 years or so, treating cancer meant one of three things: surgery, radiation, or chemotherapy. In most cases, some combination of these remains the standard of care. But cancer research does not stand still. More recent developments have included a focus on immunotherapy: using, modifying, or augmenting the patient’s natural immune system to combat cancer. Last week, we pushed the boundaries of this approach forward at the 5th annual Integrated Mathematical Oncology Workshop. Divided into four teams of around 15 people each — mathematicians, biologists, and clinicians — we competed for a $50k start-up grant. This was my 3rd time participating,^{[1]} and this year — under the leadership of Arturo Araujo, Marco Davila, and Sungjune Kim — we worked on chimeric antigen receptor T-cell therapy for acute lymphoblastic leukemia. CARs for ALL.

In this post I will describe the basics of acute lymphoblastic leukemia, CAR T-cell therapy, and one of its main side-effects: cytokine release syndrome. I will also provide a brief sketch of a machine learning approach to and justification for modeling the immune response during therapy. However, the mathematical details will come in future posts. This will serve as a gentle introduction.

## Fitness distributions versus fitness as a summary statistic: algorithmic Darwinism and supply-driven evolution

March 2, 2019 by Artem Kaznatcheev 3 Comments

For simplicity, especially in the fitness landscape literature, fitness is often treated as a scalar — usually a real number. If our fitness landscape is on genotypes then each genotype has an associated scalar value of fitness. If our fitness landscape is on phenotypes then each phenotype has an associated scalar value of fitness.

But this is a little strange. After all, two organisms with the same genotype or phenotype don’t necessarily have the same number of offspring or other life outcomes. As such, we’re usually meant to interpret the value of fitness as the mean of some random variable like number of children. But is the mean the right summary statistic to use? And if it is then which mean: arithmetic or geometric or some other?

One way around this is to simply not use a summary statistic, and instead treat fitness as a random variable with a corresponding distribution. For many developmental biologists, this would still be a simplification since it ignores many other aspects of life-histories — especially related to reproductive timing. But it is certainly an interesting starting point. And one that I don’t see pursued enough in the fitness landscape literature.

The downside is that it makes an already pretty vague and unwieldy model — i.e. the fitness landscape — even less precise and even more unwieldy. As such, we should pursue this generalization only if it brings us something concrete and useful. In this post I want to discuss two aspects of this: better integration of evolution with computational learning theory and thinking about supply driven evolution (i.e. arrival of the fittest). In the process, I’ll be drawing heavily on the thoughts of Leslie Valiant and Julian Z. Xue.

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Filed under Commentary, Models, Preliminary Tagged with evolution, fitness landscapes, fitness ontology, Leslie Valiant, machine learning