DPD-Cancer: Explainable Graph-Based Deep Learning for Small Molecule Anti-Cancer Activity Prediction

Cancer treatment planning requires decisions across multiple clinical dimensions at once. Clinicians must determine whether a patient should receive targeted molecular therapy, radiation therapy, and whether they are likely to survive beyond six months. Existing pathway-informed deep learning models have been developed and tested in isolation, making fair comparison across architectures impossible. We present the first unified benchmark for pathway-guided therapy response modeling, evaluating three biologically informed architectures, BINN, GraphPath, and PATH, across five cancer cohorts drawn from The Cancer Genome Atlas, representing 2,622 patients encoded using Reactome pathway activity scores. Each model is trained jointly on all three clinical outcomes under identical data and evaluation conditions, the first study to treat pathway-structured deep learning as a combined therapy and survival prediction problem. Our results show that no single architecture wins across all tasks: PATH performs best for targeted molecular therapy prediction overall, BINN is most reliable for survival prediction, and no model produces useful predictions for radiation therapy, as the key drivers of that decision are clinical variables not captured in gene expression data. Most strikingly, GraphPath achieves an AUROC of 0.92 on prostate targeted molecular therapy prediction, the highest score in the entire benchmark, demonstrating that lateral co-regulation structure produces exceptional discriminative power when matched to a cohort with a narrow targetable driver programme, even under conditions of extreme class imbalance at only 11% positive prevalence.

Predicting how a cell's transcriptome responds to a drug it has never seen is a core, hard problem in computational cell biology: recent benchmarks show complex models often fail to beat trivial baselines once test compounds are held out by chemistry. We study one cell line and assay, THP-1 cells profiled by DRUG-seq, scored by the active-compound weighted MSE(wMSE) of the VCPI prediction contest. We propose a staged approach: dumb baselines (untreated control and mean training-compound response) that the field keeps failing to beat; non-parametric retrieval (a Tanimoto-weighted average of a held-out compound's nearest training compounds); and a fusion stage combining a frozen chemistry embedding with retrieval-support features to predict the residual over the mean, with an uncertainty head and gene programs. On the released VCPI THP-1 drug-seq data (14,026 training compounds), under a Bemis-Murcko scaffold split, the model ranking inverts depending on the metric. Under an inverse-variance per-gene proxy, a regularized linear regression on Morgan fingerprints appears to win over the deep models, retrieval, and ChemBERTa -- the textbook "simple baselines win" result. But under the contest's true active-set metric (per-(gene, compound) Mejia weights, validated against the official scorer; mean baseline 0.535 vs the organizers' 0.507 reference), that reverses: the deep models win, our fusion decoder significantly beats the linear fingerprint baseline (-0.012 wMSE, paired bootstrap p < 10^-4), and the proxy's winner becomes the worst chemistry-aware predictor. Picking the metric picks the winner -- to our knowledge the first demonstration on real held-out drug chemistry of the metric-calibration effect established largely on genetic perturbation. We release a reproducible pipeline wired to the official scorer that emits a valid submission over the real 1064 x 12,995 grid.

Cancer drug response varies widely across tumors due to multi-layer molecular heterogeneity, motivating computational decision support for precision oncology. Despite recent progress in deep CDR models, robust alignment between high-dimensional multi-omics and chemically structured drugs remains challenging due to cross-modal misalignment and limited inductive bias. We present DeepDTF, an end-to-end dual-branch Transformer fusion framework for joint log(IC50) regression and drug sensitivity classification. The cell-line branch uses modality-specific encoders for multi-omics profiles with Transformer blocks to capture long-range dependencies, while the drug branch represents compounds as molecular graphs and encodes them with a GNN-Transformer to integrate local topology with global context. Omics and drug representations are fused by a Transformer-based module that models cross-modal interactions and mitigates feature misalignment. On public pharmacogenomic benchmarks under 5-fold cold-start cell-line evaluation, DeepDTF consistently outperforms strong baselines across omics settings, achieving up to RMSE=1.248, R^2=0.875, and AUC=0.987 with full multi-omics inputs, while reducing classification error (1-ACC) by 9.5%. Beyond accuracy, DeepDTF provides biologically grounded explanations via SHAP-based gene attributions and pathway enrichment with pre-ranked GSEA.