This review elucidates the paradigm shift in drug discovery from serendipitous exploration to rational, structure-driven polypharmacological molecular engineering, thereby providing a clear, structured guide for navigating the complexities of next-generation therapeutics.
Abstract
The traditional"one drug, one target"paradigm of structure-based drug design (SBDD) frequently proves inadequate for treating multifactorial diseases such as cancer and neurodegenerative disorders, owing to compensatory signaling pathways and the emergence of drug resistance. While polypharmacology offers a synergistic therapeutic strategy, the rational design of ligands capable of simultaneously satisfying the geometric constraints imposed by multiple targets remains a major computational bottleneck. This review positions geometric deep learning (GDL) as a powerful integrative approach to overcome these limitations. We systematically survey GDL architectures ranging from invariant graph neural networks to SE(3)-equivariant diffusion models that harness non-Euclidean molecular data to capture intrinsic three-dimensional (3D) structural interdependencies. We critically analyze GDL applications across three core dimensions, including the characterization of shared binding pockets via geometric embeddings, multi-target bioactivity prediction through heterogeneous graph fusion, and de novo generation of dual-target ligands. Particular emphasis is placed on emerging structure-conditioned generative algorithms that integrate diffusion models with reinforcement learning to autonomously resolve complex geometric conflicts between competing binding sites. Furthermore, we evaluate the pivotal role of multimodal omics integration and specialized geometric benchmarking infrastructures in validating these models. By synthesizing these methodological advances, this review elucidates the paradigm shift in drug discovery from serendipitous exploration to rational, structure-driven polypharmacological molecular engineering, thereby providing a clear, structured guide for navigating the complexities of next-generation therapeutics.
Deep neural network (DNN)-based in silico models show great promise in predicting the properties and bioactivities of novel compounds, including small molecules. Among traditional approaches, structure-based drug design (SBDD) remains a fundamental approach for drug discovery using molecular docking, scoring functions, and molecular dynamics simulations. However, these approaches are often constrained by limited flexibility, resolution, and generalizability. Geometric deep learning (GDL) offers a transformative alternative by enabling models to learn directly from non-Euclidean molecular representations, such as graphs, point clouds, and meshes, capturing critical 3D spatial relationships inherent to protein-ligand interactions. This review highlights the theoretical underpinnings and practical applications of GDL in small-molecule drug discovery, focusing on tasks including binding affinity prediction, virtual screening, de novo molecule generation, pose prediction, ADMET profiling, and protein flexibility modeling. We explore key GDL architectures, graph neural networks, SE(3)-equivariant networks, 3D convolutional neural networks, point cloud models, and geometric transformers, and assess their performance across various drug discovery benchmarks. The integration of geometry-aware AI models with experimental and computational workflows was also highlighted for its potential to streamline hit-to-lead optimization and advance rational drug design. Despite remarkable progress, the field faces challenges including limited high-quality 3D structural datasets, protein flexibility representation, and the interpretability of deep models. Addressing these issues through hybrid modeling approaches, multi-resolution learning, and self-supervised training could further elevate GDL's impact. Ultimately, GDL stands at the frontier of AI-enhanced pharmaceutical innovation, offering unprecedented precision, efficiency, and insight in the pursuit of next-generation therapeutics.
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Dual-target drug design aims to generate 3D molecules that can simultaneously interact with two target proteins, offering a promising route for discovering polypharmacological compounds against complex diseases. While recent generative models have shown encouraging performance in single-target drug design, existing dual-target approaches either focus on sequence generation or introduce an additional predictive drift term into the diffusion-based generative trajectory, which limits their ability to fully integrate feature information from both targets. We propose FusedBFN, a fused Bayesian flow network (BFN) for dual-target molecular design. FusedBFN formulates dual-target generation as distribution fusion in a unified continuous parameter space and employs a product-of-experts formulation to incorporate dual-target information throughout the generative process. To address the scarcity of dual-target structural data, we leverage a pretrained target-aware BFN model as the shared backbone. We further introduce a chemically aware prior-based alignment method and a prior-free pocket alignment strategy to construct aligned dual-target contexts. Extensive experiments demonstrate that FusedBFN generates molecules with strong binding affinity toward dual targets while maintaining favorable molecular properties.
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