# Prompt-to-Pill: Multi-Agent Drug Discovery and Clinical Simulation Pipeline

**Authors:** Ivana Vichentijevikj, Kostadin Mishev, Monika Simjanoska Misheva

PMC · DOI: 10.1093/bioadv/vbaf323 · Bioinformatics Advances · 2025-12-23

## TL;DR

This paper introduces a modular AI framework for drug discovery and clinical simulation, demonstrating a full pipeline from molecule generation to virtual patient recruitment.

## Contribution

A novel multi-agent LLM-based system for end-to-end drug discovery and clinical trial simulation is proposed and implemented.

## Key findings

- The Prompt-to-Pill framework successfully simulated drug discovery and clinical trial phases for the DPP4 target.
- Integration of generative and predictive LLMs enabled molecule creation, ADMET evaluation, and virtual patient screening.
- The system demonstrated the feasibility of using AI to streamline drug development workflows in silico.

## Abstract

This study presents a proof-of-concept, comprehensive, modular framework for AI-driven drug discovery (DD) and clinical trial simulation, spanning from target identification to virtual patient recruitment. Synthesized from a systematic analysis of 51 large language model (LLM)-based systems, the proposed Prompt-to-Pill architecture and corresponding implementation leverages a multi-agent system (MAS) divided into DD, preclinical and clinical phases, coordinated by a central Orchestrator. Each phase comprises specialized LLM for molecular generation, toxicity screening, docking, trial design, and patient matching. To demonstrate the full pipeline in practice, the well-characterized target Dipeptidyl Peptidase 4 (DPP4) was selected as a representative use case. The process begins with generative molecule creation and proceeds through ADMET (Absorption, Distribution, Metabolism, Excretion, and Toxicity) evaluation, structure-based docking, and lead optimization. Clinical-phase agents then simulate trial generation, patient eligibility screening using electronic health records (EHRs), and predict trial outcomes. By tightly integrating generative, predictive, and retrieval-based LLM components, this architecture bridges drug discovery and preclinical phase with virtual clinical development, offering a demonstration of how LLM-based agents can operationalize the drug development workflow in silico.

The implementation and code are available at: https://github.com/ChatMED/Prompt-to-Pill.

## Full-text entities

- **Genes:** CDH11 (cadherin 11) [NCBI Gene 1009] {aka CAD11, CDHOB, ESWS, OB, OSF-4, TBHS2}, DR1 (down-regulator of transcription 1) [NCBI Gene 1810] {aka NC2, NC2-BETA, NC2B, NCB2}, DPP4 (dipeptidyl peptidase 4) [NCBI Gene 1803] {aka ADABP, ADCP2, CD26, DPPIV, TP103}, CXCR3 (C-X-C motif chemokine receptor 3) [NCBI Gene 2833] {aka CD182, CD183, CKR-L2, CMKAR3, GPR9, IP10-R}
- **Diseases:** IDs (MESH:C535742), Toxicity (MESH:D064420), idiopathic pulmonary fibrosis (MESH:D054990), DD (MESH:D000081015), LLM (MESH:D007806), breast cancer (MESH:D001943)
- **Chemicals:** GPT-4o-mini (-), hydrogen (MESH:D006859), Equol (MESH:D060754)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** HOLO4K — Mus musculus (Mouse), Factor-dependent cell line (CVCL_6061)

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12800774/full.md

## References

41 references — full list in the complete paper: https://tomesphere.com/paper/PMC12800774/full.md

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Source: https://tomesphere.com/paper/PMC12800774