Drug resistance often emerges through mutations that reshape protein conformational ensembles, allowing inhibitor potency to be altered without directly disrupting protein-ligand contacts. Consequently, the molecular mechanisms underlying these effects remain difficult to identify, hindering the design of inhibitors with durable potency against rapidly evolving drug targets. To address this challenge, we developed ROBUST, a physics-informed machine learning framework that integrates experimental measurements, molecular dynamics simulations, and interpretable statistical modeling to identify energetic determinants of inhibitor potency. Using HIV-1 protease as a stringent model system for drug resistance, we determined 157 new inhibition constants and integrated them with prior measurements to establish a comprehensive experimental dataset of 364 protease-inhibitor pairs. Analysis of the corresponding molecular dynamics simulations revealed a compact network of energetic interactions that quantitatively explains how resistance mutations and inhibitor modifications jointly reshape molecular recognition and inhibitor potency across the multidimensional resistance landscape. Models constructed from these energetic signatures predicted binding free energies with high accuracy (RMSE < 1 kcal mol-1) and successfully generalized to unseen darunavir analogs. Importantly, ROBUST accurately prioritized unseen analogs based on their potency across the variant set, demonstrating its utility for identifying compounds with improved resistance profiles. Together, these results uncover the energetic principles through which resistance mutations and inhibitor modifications alter potency and establish ROBUST as a mechanistically interpretable framework for translating these insights into resistance-aware inhibitor optimization against rapidly evolving drug targets.
Intravaia, L. E., Kaur, J., Shaqra, A. M., Henes, M., Kosovrasti, K., Schroeder, V., Nalivaika, E. A., Ali, A., Kurt Yilmaz, N., Schiffer, C. A.
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