AI-Driven Drug Repositioning: A Diffusion Model Approach on Knowledge Graphs

Abstract

Drug repositioning - discovering new therapeutic applications for existing drugs - offers a promising pathway to accelerate cancer treatment development. This study proposes a diffusion model-driven framework that leverages biomedical knowledge graphs and graph-based learning to enhance drug repositioning predictions. The framework integrates data from the Semantic MEDLINE Database (SemMedDB), the Unified Medical Language System (UMLS), and the Repurposing Drugs Database (RepoDB) to construct a comprehensive therapeutic knowledge graph. Drug embeddings are generated using a one-layer Relational Graph Convolutional Network (R-GCN) incorporating semantic type-guided structural perturbations. These embeddings are refined through a flow-matching algorithm to denoise and reconstruct biologically meaningful representations. To evaluate the model's effectiveness, we apply a consensus strategy using Cosine Similarity, Euclidean Distance, and Manhattan Distance as proximity metrics. The model successfully identified, on average, 74 candidate drugs for repositioning in the context of leukemia. Qualitative analysis using t-distributed stochastic neighbor embedding (t-SNE) revealed enhanced clustering of pharmacologically relevant drugs in the denoised embedding space. Trastuzumab, in particular, emerged as a strong repositioning candidate for leukemia, supported by 156 co-mentions in PubMed. These findings demonstrate that the proposed framework improves embedding robustness and semantic fidelity, offering a powerful artificial intelligence (AI)-driven approach for precision oncology. Integrating structural noise modeling with diffusion-based denoising advances the discovery of novel drug-disease associations and holds potential for translational research and clinical hypothesis generation in drug repurposing.