Immunotherapy drug target identification using machine learning and patient-derived tumour explant validation.

Immunotherapy has revolutionized cancer treatment, yet only a minority of individuals respond clinically, necessitating alternative strategies that can benefit these patients. Novel immuno-oncology targets may achieve this through bypassing resistance mechanisms to standard therapies. We introduce Mining Immunotherapy Drug tArgetS (MIDAS), a multimodal graph neural network system for immuno-oncology target discovery. MIDAS leverages gene interactions, multi-omic patient profiles, immune cell biology, antigen processing, disease associations and phenotypic consequences of genetic perturbations. It generalizes to time-sliced data, outcompetes state-of-the-art baselines (including OpenTargets) and ranks approved targets above those in clinical development. Moreover, MIDAS recovers immunotherapy-response-associated genes in unseen patients, thereby capturing immunotherapy response determinants. Interpretability analyses reveal a reliance on autoimmunity, regulatory networks and immuno-oncology pathways. Functionally perturbing oncostatin M-oncostatin M receptor signalling, a proposed MIDAS target, in TRACERx melanoma-patient-derived explants yielded reduced dysfunctional CD8