Abstract Complex machine learning models are poised to revolutionize the treatment of diseases like acute myeloid leukemia (AML) by helping physicians choose optimal combinations of anti-cancer drugs based on molecular features. While accurate predictions are important, it is equally important to be able to learn about the underlying molecular basis of anti-cancer drug synergy. Explainable AI (XAI) offers a promising new route for data-driven cancer pharmacology, combining highly accurate models with interpretable insights into model decisions. Due to the highly correlated, high-dimensional nature of cancer transcriptomic data, however, we find that existing XAI approaches are suboptimal when applied naively to large transcriptomic datasets. We show how a novel approach based on model ensembling helps to increase the quality of explanations. We then use our method to demonstrate that a hematopoietic differentiation signature underlies synergy for a variety of anti-AML drug combinations.

Uncovering expression signatures of synergistic drug response using an ensemble of explainable AI models