Abstract
<jats:p>Target-based and structure-guided drug design remain central to modern drug discovery, but complementary strategies are needed when predefined targets or binding pockets do not fully capture disease biology. Gene-expression signatures provide scalable system-level readouts of disease and perturbation states, making them attractive inputs for phenotype-guided molecular design. However, preserving phenotypic information during molecular generation remains challenging, and chemically plausible molecules may lose connection to the intended biological response. Here, we present Tx2Mol, a transcriptome-guided framework that translates gene-expression signatures into candidate molecules while maintaining biological guidance throughout generation. We evaluated Tx2Mol across three biological settings: bulk gene perturbation, single-cell perturbation, and patient-derived disease signatures; and three validation dimensions: chemical plausibility, structural compatibility, and phenotypic preservation. Across 10 cancer-relevant bulk gene-perturbation benchmarks, Tx2Mol outperformed 9 transcriptome-guided baselines, improving maximum Tanimoto similarity to known ligands by 24.10% on average and by 50.67% on HDAC1. Structure-based analyses further supported structurally novel candidates with favorable predicted target binding. Tx2Mol also generalized to noisy single-cell perturbation profiles and preserved drug-induced transcriptional responses through in silico drug-perturbation validation. Patient-derived disease signatures further guided molecular generation toward approved-drug chemical space. Together, these results support gene-expression phenotypes as actionable guidance signals for phenotype-directed molecular design and candidate prioritization.</jats:p>