UniD3: A Knowledge Graph-Enhanced RAG Framework for Drug-Disease Discovery and Reasoning
Authors: Qing Wang, Tianshi Liu, Minghao Zhou, Jialu Liang, Sen Guo, Guangyu Wang, Jing Su, Qianqian Song
Organizations: Department of Health Outcomes and Biomedical Informatics, University of Florida, Florida, USA · Department of Hematology, H. Lee Moffitt Cancer Center and Research Institute, Florida, USA · Center for Bioinformatics and Computational Biology, Houston Methodist Research Institute, Houston, TX, USA · Department of Cardiothoracic Surgery, Weill Cornell Medicine, Cornell University, New York, NY, USA · Department of Biostatistics and Health Data Science, Indiana University School of Medicine, IN, USA
Systematic characterization of drug-disease relationships is essential for drug discovery and repurposing, yet is hindered by the heterogeneity and rapid growth of biomedical literature. Existing datasets rely on labor-intensive curation and are often incomplete, while LLM-only approaches suffer from hallucination and weak evidence grounding. We introduce UniD3, a unified framework that integrates Large Language Models with Knowledge Graph-enhanced Retrieval-Augmented Generation (KG-RAG) to extract, organize, and validate drug-disease knowledge across Drug-Disease Matching (DDM), Drug Effectiveness Assessment (DEA), and Drug-Target Analysis (DTA). UniD3 processes 157,849 PubMed articles with Llama 3.3-70B and constructs knowledge graphs via a dual-stage strategy combining paper-level extraction with KG-level consolidation centered on drug and disease entities. These graphs support KG-RAG-based generation of structured datasets, evaluated through external benchmarks, fuzzy matching with curated resources, and clinician review. UniD3 produces six knowledge graphs and large-scale datasets, including 28,915 DDM, 15,042 DEA, and over 4,000 DTA QA pairs. External validation shows strong performance (F1: 0.85-0.87 for DDM/DEA; 0.82 for DTA), with clinician review confirming high reliability (AUROC = 0.90). KG-RAG-augmented models outperform standalone LLMs, and the UniD3 chatbot enables interpretable, citation-supported exploration of drug-disease relationships. UniD3 provides a scalable, extensible framework for transforming unstructured biomedical literature into high-quality, structured drug-disease knowledge, supporting AI-driven discovery, repurposing, and precision medicine.
Automated Drug Combination Extraction (DCE) from large-scale biomedical literature is crucial for advancing precision medicine and pharmacological research. However, existing relation extraction methods primarily focus on binary interactions and struggle to model variable-length n-ary drug combinations, where complex compatibility logic and distributed evidence need to be considered. To address these limitations, we propose RexDrug, an end-to-end reasoning-enhanced relation extraction framework for n-ary drug combination extraction based on large language models. RexDrug adopts a two-stage training strategy. First, a multi-agent collaborative mechanism is utilized to automatically generate high-quality expert-like reasoning traces for supervised fine-tuning. Second, reinforcement learning with a multi-dimensional reward function specifically tailored for DCE is applied to further refine reasoning quality and extraction accuracy. Extensive experiments on the DrugComb dataset show that RexDrug consistently outperforms state-of-the-art baselines for n-ary extraction. Additional evaluation on the DDI13 corpus confirms its generalizability to binary drugdrug interaction tasks. Human expert assessment and automatic reasoning metrics further indicates that RexDrug produces coherent medical reasoning while accurately identifying complex therapeutic regimens. These results establish RexDrug as a scalable and reliable solution for complex biomedical relation extraction from unstructured text. The source code and data are available at https://github.com/DUTIR-BioNLP/RexDrug
Workflows in drug-target interaction (DTI) assessment require integrating heterogeneous data from predictive models, curated resources, and observations from experimental literature. This evidence can be incomplete or conflicting. DrugAgent is a large language model (LLM)-based multi-agent system focused on DTI evidence integration that integrates outputs from machine learning, knowledge graph, and retrieval-augmented generation (RAG) agents. DrugAgent converts agent outputs into interpretable representations, then summarizes conflict across the evidence. We evaluated DrugAgent on kinase screening data of 900 pairs spanning 178 kinases and 42 inhibitors, and an androgen receptor antagonist screening benchmark. On the kinase dataset, LLM-as-a-Judge evaluation indicated outputs were faithful to input evidence in 98.8% of cases. Biological plausibility of returned summarization was high (scores 3-4 out of 5) across ground-truth classes: 79% of Weak activity labels cases (81% for Moderate/77% Strong); Strong cases received higher scores than Weak/Moderate. Label stability showed 98% agreement across runs. Results on the antagonist benchmark were consistent with the kinase dataset. Retrieved literature provided the greatest benefit when direct drug-target evidence was available, highlighting the importance of evidence availability for RAG-based integration. DrugAgent provides heterogeneous evidence-grounded DTI assessment, complementing standalone DTI prediction. We provide strategies to model agreement, conflict, and uncertainty in biomedical evidence integration. Code: https://github.com/sciluna/DrugAgent.
Manually curated biomedical repositories -- spanning bioactivity, genomics, and chemistry -- are expensive to maintain, lag behind primary literature, and discard experimental context, obscuring nuances needed to assess data correctness and coverage. We show that PubMed itself can be autonomously and cost-effectively turned into structured datasets that are larger, more nuanced, and more accurate than the curated databases they replace. We present three coupled contributions: (1) an LLM-based entity-tagging pipeline, grounded in nine biomedical ontologies, that tags 4.5B entities across 19 categories in a 22.5M-paper, 2.5T-token PubMed corpus; (2) hybrid sparse-dense retrieval supporting entity-filtered semantic queries over the tagged corpus; and (3) Starling, a multi-agent deep research system that, given only a natural-language task description, designs precision- and recall-targeted retrieval filters, induces an extraction schema, and emits structured records with nuance-rich fields and supporting passages. Across six tasks -- blood-brain barrier permeability, oral bioavailability, acute toxicity (LD50), gene-disease associations, protein subcellular localization, and chemical reactions -- Starling produces ~6.3M records (91K-3M per task); several are, to our knowledge, the largest public datasets for their property. Frontier-model rejection of our extractions is 0.6-7.7% across tasks, far below error rates we measure on widely used curated counterparts (e.g., 16.5% on BBB_Martins, 7.3% on Bioavailability_Ma). Beyond scale and accuracy, the supporting passages carry nuance tabular databases discard -- e.g., oral bioavailability may depend on fed vs. fasted state. Together, the corpus, retrieval, and agent establish a foundation for AI-driven therapeutic design. Code and datasets: https://github.com/starling-labs/starling.