An explainable artificial intelligence-based typification of chronic inflammatory responses enhances glioma prognosis

Glioma is one of the most aggressive solid brain tumors with a poor prognosis. A chronic tumor inflammatory microenvironment drives glioma promotion and progression. The neutrophil-to-lymphocyte ratio and other clinicopathological variables usually serve as prognostic glioma markers. However, they are not ubiquitous prognostic markers for glioma as they fail to reveal the intricacy between the glioma-specific tumor inflammatory microenvironment and the systemic inflammatory responses, especially those chronic inflammatory responses, which vary among individuals fabricating diverse prognostic outcomes. Here, we introduced an explainable artificial intelligence model to typify chronic inflammatory responses as prognostic markers for glioma using 694-patients data from The Cancer Genome Atlas. We characterized the glioma-specific personalized inflammatory mediators using multi-layered regulators such as transcriptional networks, cellular infiltration markers, and cellular senescence markers, which identified five unique chronic inflammatory responses (p-value<0.0001). We defined its prognostic significance using overall survival analyses. The chronic inflammatory responses were positively correlated with poor overall survival in glioma. The patients with higher chronic inflammatory responses showed significantly shorter overall survival than those with lower chronic inflammatory responses. Interestingly, optimizing those chronic inflammatory responses improved the overall survival of glioma patients. We identified the effector genes within the personalized inflammatory mediators networks, indicating them as the targets for optimizing individualized chronic inflammatory response profiles through co-drug intervention. SignificanceExplainable artificial intelligence-based typification of chronic inflammatory responses accelerates glioma prognosis and supports co-drug discovery to modulate inflammatory responses alongside cancer therapy, suggested by 694-glioma patients data analysis.