An Interpretable Min-Max Layered Neural Network for Real-Time Immune Feedback Monitoring in Immunotherapy

Selvaganapathi Sennan ORCID ,  Mantena Krishna Satya Varma ORCID ,  Vidhyasree Muralidoss ORCID ,  Thirugnanam Thirumurugan ORCID ,  Simon Jeyakumar ORCID ,  Immanuvel Arokia James Kaspar ORCID
    Received: 18 June 2026; Revised: 7 July 2026; Accepted: 27 July 2026; Published: 20 September 2026

    Abstract

    Cytokines, immune cells, and immune checkpoint molecules are interconnected and create feedback loops that either activate or suppress immunity. Correct modelling of these dynamic interactions is critical to understand immune regulation and to develop adaptive immunotherapeutic approaches. Traditional deep learning models, on the other hand, tend to be black-box predictors, which lack biological interpretability and clinical transparency. This paper presents a new Min-Max Layered Neural Network (MML-NN) architecture to model and monitor immune feedback processes in real-time. The architecture includes biologically inspired min-max operations to model threshold-dependent immune activation, inhibition signals and temporal feedback, and increase the interpretability. The framework was tested through simulated longitudinal immune biomarker data such as cytokine profiles, CD8⁺ T-cell counts and PD-L1 expression, and is compared to Long Short-Term Memory (LSTM), Gated Recurrent Unit (GRU), feedforward neural network and Transformer-based models as proof of concept. Robustness was evaluated by 10 independent experimental runs, 95% confidence interval analysis and by component-wise ablation studies. The full MML-NN attained a 93.10% prediction accuracy, 91.40% F1 score, six time-step prediction lead time and computational latency of 12.5 ms, while surpassing the comparison models in terms of predictive accuracy, early immune-state transition detection, and interpretability. Repeated experiments showed low variability, while ablation results confirmed the importance of all architectural components. The framework was validated using simulated data, but it offers a foundation for future clinical validation and AI-driven precision immunotherapy decision support.

    Keywords

    References

    1. 1. Chen, D.S.; Mellman, I. Elements of cancer immunity and the cancer–immune set point. Nature 2017, 541, 321–330.
    2. 2. Waldman, A.D.; Fritz, J.M.; Lenardo, M.J. A guide to cancer immunotherapy: From T cell basic science to clinical practice. Nat. Rev. Immunol. 2020, 20, 651–668.
    3. 3. Sharpe, A.H.; Pauken, K.E. The diverse functions of the PD1 inhibitory pathway. Nat. Rev. Immunol. 2018, 18, 153–167.
    4. 4. Sharma, P.; Allison, J.P. Dissecting the mechanisms of immune checkpoint therapy. Nat. Rev. Immunol. 2020, 20, 75–76.
    5. 5. Kalbasi, A.; Ribas, A. Tumour-intrinsic resistance to immune checkpoint blockade. Nat. Rev. Immunol. 2020, 20, 25–39.
    6. 6. Topalian, S.L.; Taube, J.M.; Anders, R.A.; et al. Mechanism-driven biomarkers to guide immune checkpoint blockade in cancer therapy. Nat. Rev. Cancer 2016, 16, 275–287.
    7. 7. O’Donnell, J.S.; Teng, M.W.; Smyth, M.J. Cancer immunoediting and resistance to T cell-based immunotherapy. Nat. Rev. Clin. Oncol. 2019, 16, 151–167.
    8. 8. Murphy, K.; Weaver, C. Janeway's Immunobiology, 9th ed.; Garland Science: New York, NY, USA, 2016.
    9. 9. Abbas, A.K.; Lichtman, A.H.; Pillai, S. Cellular and Molecular Immunology, 10th ed.; Elsevier: Amsterdam, The Netherlands, 2021.
    10. 10. Konstorum, A.; Vella, A.T.; Adler, A.J.; et al. Addressing current challenges in cancer immunotherapy with mathematical and computational modelling. J. R. Soc. Interface 2017, 14, 20170150.
    11. 11. Finotello, F.; Rieder, D.; Hackl, H.; et al. Next-generation computational tools for interrogating cancer immunity. Nat. Rev. Genet. 2019, 20, 724–746.
    12. 12. Addala, V.; Newell, F.; Pearson, J.V.; et al. Computational immunogenomic approaches to predict response to cancer immunotherapies. Nat. Rev. Clin. Oncol. 2024, 21, 28–46.
    13. 13. Hudson, D.; Fernandes, R.A.; Basham, M.; et al. Can we predict T cell specificity with digital biology and machine learning? Nat. Rev. Immunol. 2023, 23, 511–521.
    14. 14. Esteva, A.; Robicquet, A.; Ramsundar, B.; et al. A guide to deep learning in healthcare. Nat. Med. 2019, 25, 24–29.
    15. 15. Topol, E.J. High-performance medicine: The convergence of human and artificial intelligence. Nat. Med. 2019, 25, 44–56.
    16. 16. Li, B.; Luo, R.; Huang, K.; et al. Decoding immunotherapy response through computational modeling. Nat. Commun. 2026, 17, 5256.
    17. 17. Krishna, S.; Robbins, P.F.; Lowery, F.J.; et al. Hallmarks and correlates of effective adoptive cell immunotherapy for cancer. Nat. Rev. Immunol. 2026, 1–18.
    18. 18. Lundberg, S.M.; Lee, S.I. A unified approach to interpreting model predictions. In Proceedings of the 31st Conference on Neural Information Processing Systems (NIPS 2017), Long Beach, CA, USA, 4–9 December 2017.
    19. 19. Bharati, S.; Mondal, M.R.H.; Podder, P. A review on explainable artificial intelligence for healthcare: Why, how, and when? IEEE Trans. Artif. Intell. 2023, 5, 1429–1442.
    20. 20. Vilone, G.; Longo, L. Explainable artificial intelligence: A systematic review. arXiv preprint 2020, arXiv:2006.00093.
    21. 21. Goodfellow, I.; Warde-Farley, D.; Mirza, M.; et al. Maxout networks. In Proceedings of the 30th International Conference on Machine Learning, Atlanta, GA, USA, 16–21 June 2013; pp. 1319–1327.
    22. 22. LeCun, Y.; Bengio, Y.; Hinton, G. Deep learning. Nature 2015, 521, 436–444.
    23. 23. Schmidhuber, J. Deep learning in neural networks: An overview. Neural Netw. 2015, 61, 85–117.
    24. 24. Vaswani, A.; Shazeer, N.; Parmar, N.; et al. Attention is all you need. In Proceedings of the 31st Conference on Neural Information Processing Systems (NIPS 2017), Long Beach, CA, USA, 4–9 December 2017.
    25. 25. Russell, S.; Norvig, P. Artificial Intelligence: A Modern Approach, 4th ed.; Pearson: Hoboken, NJ, USA, 2020.
    26. 26. Litjens, G.; Kooi, T.; Bejnordi, B.E.; et al. A survey on deep learning in medical image analysis. Med. Image Anal. 2017, 42, 60–88.
    27. 27. Samek, W.; Montavon, G.; Vedaldi, A.; et al. Explainable AI: Interpreting, Explaining and Visualizing Deep Learning; Springer Nature: Cham, Switzerland, 2019.
    28. 28. Aggarwal, V.; Workman, C.J.; Vignali, D.A. LAG-3 as the third checkpoint inhibitor. Nat. Immunol. 2023, 24, 1415–1422.
    29. 29. Mellman, I.; Chen, D.S.; Powles, T.; et al. The cancer-immunity cycle: Indication, genotype, and immunotype. Immunity 2023, 56, 2188–2205.
    30. 30. Xu, M.; Lu, M.; Liu, P.; et al. ProTCR: A protein language model-driven framework for decoding TCR-antigen recognition toward precision immunotherapies. Brief. Bioinform. 2026, 27, bbaf716.
    31. 31. Kong, J.; Ha, D.; Lee, J.; et al. Network-based machine learning approach to predict immunotherapy response in cancer patients. Nat. Commun. 2022, 13, 3703.
    32. 32. Jiang, Y.; Immadi, M.S.; Wang, D.; et al. IRnet: Immunotherapy response prediction using pathway knowledge-informed graph neural network. J. Adv. Res. 2025, 72, 319–331.
    33. 33. Li, X.; Pan, B.; He, Y.; et al. PathHDNN: A pathway hierarchical-informed deep neural network framework for predicting immunotherapy response and mechanism interpretation. Genome Med. 2025, 17, 152.
    34. 34. Li, Z.; Li, J.; Kuang, K.; et al. SimTA++: Simple attention neural network for clinical asynchronous time series. Neural Netw. 2025, 191, 107735.
    35. 35. Saad, M.B.; Al-Tashi, Q.; Hong, L.; et al. Machine-learning driven strategies for adapting immunotherapy in metastatic NSCLC. Nat. Commun. 2025, 16, 6828.
    36. 36. Hoebel, K.V.; Lindsay, J.R.; Altreuter, J.; et al. Graph neural network modeling of spatial tumor-immune interactions identifies prognostic cellular niches in non-small cell lung cancer. NPJ Precis. Oncol. 2026, 10, 158.
    37. 37. Jeong, H.; Oh, J.; Choi, Y.L. GraphTME: Graph-based framework for predicting immunotherapy response by interpreting tumour microenvironment interactions using spatial transcriptomics. npj Syst. Biol. Appl. 2026. DOI: https://doi.org/10.1038/s41540-026-00735-x
    38. 38. Monkman, J.; Kilgallon, A.; Lawler, C.; et al. Metabolic characterization of tumor-immune interactions by multiplexed immunofluorescence reveals spatial mechanisms of immunotherapy response in non-small cell lung carcinoma (NSCLC). Nat. Commun. 2026, 17, 837.
    39. 39. Butner, J.D.; Dogra, P.; Chung, C.; et al. Hybridizing mechanistic modeling and deep learning for personalized survival prediction after immune checkpoint inhibitor immunotherapy. npj Syst. Biol. Appl. 2024, 10, 88.
    ×