02326nas a2200385 4500000000100000000000100001008004100002260001500043653001500058653001100073653004500084653002100129653003000150100002200180700001200202700002200214700001700236700001800253700001900271700001900290700001600309700002300325700001600348700001900364700001700383700001900400700001800419700001800437245008100455856005500536300001000591490000700601520131800608022001401926 2025 d c2025-12-1510aCNS cancer10aCancer10aComputational platforms and environments10aDrug development10aHigh-throughput screening1 aWilliam C. Wright1 aMin Pan1 aGregory A. Phelps1 aJonathan Low1 aDuane Currier1 aAnkita Sanjali1 aMarlon Trotter1 aJihye Hwang1 aRichard H. Chapple1 aXueying Liu1 aDeclan Bennett1 aYinwen Zhang1 aRichard E. Lee1 aTaosheng Chen1 aPaul Geeleher00aAn open-source screening platform accelerates discovery of drug combinations uhttps://www.nature.com/articles/s41467-025-66223-8 a110050 v163 aDrug combinations are essential to modern medicine, but their discovery remains slow and inefficient as experimental complexity expands rapidly with each additional drug tested. Although modern liquid handling systems enable complex and highly customizable experimental designs, a lack of strategies integrating these technologies with combination-specific analytical methods has limited throughput. Here we introduce Combocat, an open-source and streamlined framework that combines acoustic liquid handling protocols with machine learning-based inference to achieve ultrahigh-throughput drug combination screening. Using Combocat, we generate a reference dataset of over 800 unique combinations in a dense 10 × 10 matrix format across multiple cell types, and use this to train a predictive model that accurately infers drug combination effects from sparse data, drastically reducing the number of experimental measurements required. As proof of concept, we screened 9,045 combinations in a neuroblastoma cell line—the largest number of combinations tested in a single cell line to date—achieved using minimal resources. By integrating advanced drug dispensing technologies with predictive computational modeling, Combocat provides a scalable solution to accelerate the discovery of novel drug combinations. a2041-1723