What is multi-drug attribution?

Multi-drug attribution is the process of determining which drug or drugs in a combination regimen most likely caused a given adverse event. In oncology, combination therapy is the standard of care: FOLFOX, FOLFIRI, carboplatin and paclitaxel, checkpoint inhibitor combinations, antibody-drug conjugates, CAR-T plus bridging chemotherapy. When fatigue, neutropenia, or hepatic injury occurs, attributing it correctly is the foundation of dose modification, SAE narrative writing, and downstream pharmacovigilance signal detection.