Holistic Drug Development (HDD) = Holistic Decision Making

Finally found the time to read the excellent BioPharmaTrend.com report "Beyond Legacy Tools: Defining Modern AI Drug Discovery for 2025 and Beyond" (thank you Andrii Buvailo, Ph.D. for the pointer!). The report's tone is (cautiously?) upbeat 📈 but it does ask some hard questions about how tangible the field's success really is. Unquestionably successful Phase 3 studies will be the ultimate test, questionable Phase 3 study results will keep the debate going. As a side note, it is an opinionated report and not an exhaustive review of the space as it is missing lots of players.

But the biggest insight from this report may be the framing of AI drug discovery as holistic decision making. The excerpt below provides the essence of the framework. The ability to optimize, or at least design, the end-to-end process, from patient need to biological hypothesis discovery all the way back to the patient is perhaps the single most important concept here, made possible by integrating the steps into an AI wrapper. I don't think any company is doing this today: big Pharma functions are too siloed, biotech is singularly focused on FDA approval or Phase 2 success, and the AI champions (Recursion, Insilico Medicine, OWKIN, Iambic Therapeutics, Verge Genomics), while at the forefront of that effort, are not quite there yet (tantalizing close?).

"The novelty and ambition of the AIDD approach is about redesigning the existing mainstream drug discovery paradigm into something different.

We suggest calling it Holistic Drug Development (HDD).

Starting from modeling the entirety of real-world data about patients (coming from specimens, analytical samples, EHRs, and other biomedical data), and taking into account all available preclinical data and experience, and building the path down to a relevant underlying hypothesis on a molecular level. And then, walking that path in reverse — from the newly discovered hypothesis, via drug design and development, back to the patient. Hopefully, with the improved probability of success. We believe we are still years away from this reality, but a number of companies are already building pieces of the puzzle of the industrialized research workflow of the future."

Alex Zhavoronkov, Simon Birksø Larsen, Cassie Kozyrkov, Sebastian Uribe, Aaron Schacht, Elliot Hershberg