Abstract
Although remarkable progresses have been made in the cancer treatment, existing anti-cancer drugs are associated with increasing risk of heart failure, variable drug response, and acquired drug resistance. To address these challenges, for the first time, we develop a novel genome-scale multi-target screening platform 3D-REMAP that integrates data from structural genomics and chemical genomics as well as synthesize methods from structural bioinformatics, biophysics, and machine learning. 3D-REMAP enables us to discover marked drugs for dual-action agents that can both reduce the risk of heart failure and present anti-cancer activity. 3D-REMAP predicts that levosimendan, a drug for heart failure, inhibits serine/threonine-protein kinase RIOK1 and other kinases. Subsequent experiments confirm this prediction, and suggest that levosimendan is active against multiple cancers, notably lymphoma, through the direct inhibition of RIOK1 and RNA processing pathway. We further develop machine learning models to identify cancer cell-lines and patients that may respond to levosimendan. Our findings suggest that levosimendan can be a promising novel lead compound for the development of safe and effective multi-targeted cancer therapy, and demonstrate the potential of genome-wide multi-target screening in designing polypharmacology and drug repurposing for precision medicine.