In 2010, Ivana Bozic and Martin Nowak co-authored a pivotal mathematical study that showed that most solid tumors contain 40 to 100 genetic mutations, but that on average only 5 to 15 of those actually drive tumor growth. The findings were essential to the researchers at Johns Hopkins and elsewhere because they demonstrated the importance of isolating a key minority of mutated tumor cells for effective inhibitor treatment.
“Mathematics in medical research reveals patterns that are otherwise hidden,” remarked Epstein, who maintains a frequent presence at PED. “It’s exhilarating when a mathematician can determine molecular and cellular behavior with the precision of an engineer and share those findings with physicians.”
Also in 2010, PED presented to Bert Vogelstein, professor and director of the Ludwig Center for Cancer Genetics and Therapeutics at the Johns Hopkins Kimmel Cancer Center and the Howard Hughes Medical Institute, a mathematical model showing the genetic evolution of pancreatic-cancer cells from the time of initial mutation to non-primary malignant cells. What Nowak’s team had found was surprising: that pancreatic cancer, one of the most lethal forms of cancer, is not fast and furious as had been thought, but rather slow growing. In fact, given the amount and type of genetic disparity between the cellular stages, it appears that it takes about ten years for an initiating mutation to develop to a parental, non-metastatic founder cell and another six years for cells to become malignant.
The significance of these findings is that they highlighted the importance of isolating pancreatic mutations prior to metastasis. Johns Hopkins scientists are now focusing on developing a screening method for pancreatic cancer similar to the protocol used for breast and colon cancers. Though early stages of pancreatic cancer cause no known symptoms, the Johns Hopkins team is looking into pancreatic-screening endoscopies for patients of a certain age.
Over the past two years, Nowak and his team have also collaborated with Johns Hopkins to develop a database to map and predict the effect of drugs on the HIV virus. Like cancer cells, HIV often develops resistance to drug cocktails. This is a major problem for patients, and the trial and error of clinical trials can be hugely debilitating. Using data collected from thousands of blood tests on more than 20 anti-HIV drugs, the model calculates each drug’s ability to suppress viral replication and avoid resistant HIV strains. The model also factors in different drug combinations and dosages, and information about the patient such as blood type, age, and sex, to arrive at the most precisely engineered predictor of results for future patients.
At least on the surface, Epstein’s motivation for applied science differs from Nowak’s. While Nowak is a practicing Roman Catholic and a declared humanist with a desire to serve society, Epstein is first and foremost a problem solver, interested in strategy and intellectual puzzles. He is equally devoted to physics, artificial intelligence, and the human brain. According to Nowak, Epstein was fascinated with his game theory of win–stay, lose–shift and eager to see how it could be applied to the markets. That is not to say that Epstein has no interest in purely humanistic endeavors. He has given thoughtfully to countless organizations that help educate underprivileged children, notably in the U.S. Virgin Islands, where his foundation is based. But his essence is in uncovering unsolved problems, a perhaps insatiable desire.
Much has been written about the Program for Evolutionary Dynamics and Martin Nowak’s work. Nowak is the recipient of numerous awards and the author of several books. And while Jeffrey Epstein remains an obscure figure, tarnished now by a series of scandals involving underage women, one of which led to an 18-month jail sentence, he is nonetheless the talented catalyst, the accelerator of all this medical discovery. Whatever his ignominy, Epstein’s continued bond with Nowak and PED emphasizes that nature is not fastidious nor judgmental, nor is its dynamic always gradual. Discovery can be sparked into being by an unlikely source, and its value does not depend on the makeup of its originator.
— Christina Galbraith is a science writer and the head of media for the Jeffrey Epstein VI Foundation. Her press has been picked up by CNBC, Reuters, Bloomberg, the Wall Street Journal, and other outlets. Her work can be found at www.jeffreyepstein.org.