Cross-modal transfer enables zero-shot prediction of drug responses across cell types

Genetic perturbation responses capture the functional consequences of gene-level interventions, providing functional information for drug-response prediction beyond baseline gene expression. Within the same cellular context, genetic and chemical perturbations engage shared regulatory networks, providing a biological basis for transferring response information between perturbation modalities. Here we introduce GRAFT, a framework that combines genetic-to-chemical transfer with cross-context prediction to infer drug-induced transcriptional responses without drug measurements in the target context. Across benchmarked LINCS and external contexts, GRAFT improved response correlation, directional agreement and magnitude reconstruction over competing methods, particularly for drugs with context-dependent responses. GRAFT-Adapt further refines predictions of unmeasured responses using a small number of drug measurements from the target context. GRAFT-Atlas spans 13 cellular contexts and 7,856 drug catalog entries, comprising 102,128 predictions for drug-context combinations. The atlas captured recognizable pharmacological neighborhoods, shared functional programs, context-dependent transcriptional changes and structural-functional associations supported by molecular docking. Across ten iPSC lines from distinct donors, GRAFT identified candidate inter-donor differences, with functional support for selected candidates from measured genetic perturbation responses. Together, GRAFT enables perturbation-informed prediction and comparison of drug responses across cellular contexts.