Drug combinations are becoming a standard treatment of many complex diseases due to their capability to overcome resistance to monotherapy. In the current preclinical drug combination screening, the top combinations for further study are often selected based on synergy alone, without considering the combination efficacy and toxicity effects, even though these are critical determinants for the clinical success of a therapy. To promote the prioritization of drug combinations based on integrated analysis of synergy, efficacy and toxicity profiles, we implemented a web-based open-source tool, SynToxProfiler (Synergy-Toxicity-Profiler). When applied to 20 anti-cancer drug combinations tested both in healthy control and T-cell prolymphocytic leukemia (T-PLL) patient cells, as well as to 77 anti-viral drug pairs tested in Huh7 liver cell line with and without Ebola virus infection, SynToxProfiler prioritized as top hits those synergistic drug pairs that showed higher selective efficacy (difference between efficacy and toxicity), which offers an improved likelihood for clinical success.
Author summaryHigh-throughput combinatorial screening is an established approach to identify candidate drug combinations to be further developed as safe and effective treatment options for many diseases, such as various types of cancers, bacterial, malarial, and viral infections. The selection of top performing drug combinations for further development is an important step for the success of the screen, where not only the synergy but also selective efficacy and potential toxicity of the drug pairs should be critically assessed. Currently, there is no method available for this; therefore, we developed SynToxProfiler tool, which was demonstrated in two different application cases to prioritize synergistic drug pairs with higher efficacy and lower toxicity as top hits, providing thus an increased likelihood for their clinical success.PLOS Computational Biology | https://doi.