The design of novel, safe, and effective
drugs to treat
human diseases
is a challenging venture, with toxicity being one of the main sources
of attrition at later stages of development. Failure due to toxicity
incurs a significant increase in costs and time to market, with multiple
drugs being withdrawn from the market due to their adverse effects.
Cardiotoxicity, for instance, was responsible for the failure of drugs
such as fenspiride, propoxyphene, and valdecoxib. While significant
effort has been dedicated to mitigate this issue by developing computational
approaches that aim to identify molecules likely to be toxic, including
quantitative structure–activity relationship models and machine
learning methods, current approaches present limited performance and
interpretability. To overcome these, we propose a new web-based computational
method, cardioToxCSM, which can predict six types
of cardiac toxicity outcomes, including arrhythmia, cardiac failure,
heart block, hERG toxicity, hypertension, and myocardial infarction,
efficiently and accurately. cardioToxCSM was developed
using the concept of graph-based signatures, molecular descriptors,
toxicophore matchings, and molecular fingerprints, leveraging explainable
machine learning, and was validated internally via different cross
validation schemes and externally via low-redundancy blind sets. The
models presented robust performances with areas under ROC curves of
up to 0.898 on 5-fold cross-validation, consistent with metrics on
blind tests. Additionally, our models provide interpretation of the
predictions by identifying whether substructures that are commonly
enriched in toxic compounds were present. We believe cardioToxCSM will provide valuable insight into the potential cardiotoxicity
of small molecules early on drug screening efforts. The method is
made freely available as a web server at .