Virtual
high throughput screening (vHTS) in drug discovery is a
powerful approach to identify hits: when applied successfully, it
can be much faster and cheaper than experimental high-throughput screening
approaches. However, mainstream vHTS tools have significant limitations:
ligand-based methods depend on knowledge of existing chemical matter,
while structure-based tools such as docking involve significant approximations
that limit their accuracy. Recent advances in scientific methods coupled
with dramatic speedups in computational processing with GPUs make
this an opportune time to consider the role of more rigorous methods
that could improve the predictive power of vHTS workflows. In this
Perspective, we assert that alchemical binding free energy methods
using all-atom molecular dynamics simulations have matured to the
point where they can be applied in virtual screening campaigns as
a final scoring stage to prioritize the top molecules for experimental
testing. Specifically, we propose that alchemical absolute binding
free energy (ABFE) calculations offer the most direct and computationally
efficient approach within a rigorous statistical thermodynamic framework
for computing binding energies of diverse molecules, as is required
for virtual screening. ABFE calculations are particularly attractive
for drug discovery at this point in time, where the confluence of
large-scale genomics data and insights from chemical biology have
unveiled a large number of promising disease targets for which no
small molecule binders are known, precluding ligand-based approaches,
and where traditional docking approaches have foundered to find progressible
chemical matter.