A multi-agent molecular optimization framework leads to a rapid-recovery intravenous anesthetic candidate with an improved safety margin

Abstract

Lead optimization, the systematic refinement of therapeutic compounds through iterative structural modification, faces a dual challenge in modern drug discovery: navigating astronomically vast molecular design spaces while balancing conflicting demands on potency, pharmacokinetics, and safety. We present MASCOT (Multi-Agent SearCh for molecular OpTimization), a role-specialized multi-agent framework for molecular optimization. Integrated with a chemically constrained graph-editing search, MASCOT coordinates three specialized agents: a trade-off agent that reprioritizes competing objectives, a strategy agent that adapts how molecular edits are proposed, and a reflection agent that distills lessons from previous decisions. Computational experiments showed that MASCOT achieved the best performance over competing methods on six benchmark settings. On the SARS-CoV-2 main protease task, its mean docking-score improvement was 3.6 times that of the strongest baseline. Applied to the clinically used anesthetic remimazolam (RM), MASCOT prioritized RM-1, which showed a shorter liver microsomal half-life, higher brain exposure, and a larger therapeutic index than RM. Subsequent derivative design yielded RM-7. Extensive animal studies established RM-7 as a rapid-recovery intravenous anesthetic candidate with greater potency, faster functional recovery, a wider safety margin, and preserved flumazenil reversibility. These results demonstrate that multi-agent coordination can link adaptive molecular search to medicinal chemistry and experimental pharmacology.