Announcement • 9h
Insilico Medicine Initiates Phase III Clinical Trial For Rentosertib, Its AI-Empowered TNIK Inhibitor For Idiopathic Pulmonary Fibrosis
Insilico Medicine announced the initiation of the Phase III clinical trial for Rentosertib, its potentially first-in-class oral small-molecule inhibitor targeting TNIK for the treatment of idiopathic pulmonary fibrosis (IPF), a progressive, age-related fibrotic lung disease with high unmet medical need. Rentosertib, formerly known as ISM001-055 /INS018_055, was discovered and designed through Insilico's Pharma.AI platform. The program combines a novel fibrosis target prioritized by Biology42: PandaOmics, Insilico's AI-powered biology engine, with a novel small molecule generated and optimized through Chemistry42, Insilico's generative chemistry platform. Insilico leverages PandaOmics for indication prioritization and Medicine42's inClinico platform to predict and improve the program's clinical trial outcomes. The program's discovery-to-clinic path was published in Nature Biotechnology, while randomized Phase IIa clinical results were published in Nature Medicine and presented at the American Thoracic Society (ATS) 2025 International Conference. The initiation of Rentosertib's Phase III clinical trial marks a major late-stage milestone for AI-driven drug discovery: a medicine whose target was identified with AI, whose chemical structure was designed with generative AI, and whose clinical development is aimed at a severe age-related disease in which current approved antifibrotic therapies can slow progression but do not reverse the degenerative course of disease. To evaluate Rentosertib in this next stage of development, the upcoming Phase III clinical trial is a prospective, randomized, double-blind, placebo-controlled, parallel-group Phase III study. It will be led by Professor Zuojun Xu of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences as the Leading Principal Investigator (Leading PI), with Academician Nanshan Zhong of the Chinese Academy of Engineering, and President Chang Chen of Shanghai Pulmonary Hospital serving as Co-Leading Principal Investigators (Co-Leading PIs). The study is expected to enroll 320 patients with idiopathic pulmonary fibrosis (IPF) and is designed to systematically evaluate the efficacy and safety of once-daily Rentosertib administered over 52 weeks. IPF is a chronic, progressive lung-scarring disease that disproportionately affects older adults. As fibrosis accumulates, lung tissue becomes stiff and scarred, making breathing increasingly difficult and leading to irreversible decline in lung function. The median survival after diagnosis is commonly reported at approximately two to four years, and there remains a substantial need for disease-modifying treatments that can meaningfully alter the clinical course. TNIK is a serine/threonine kinase implicated in fibrosis-driving and inflammation-related pathways including Wnt, TGF-ß, Hippo/YAP-TAZ, JNK and NF-?B signaling. Insilico identified TNIK as a high-priority fibrosis target using PandaOmics by integrating multi-omics data from fibrotic tissues, biological network analysis, causal inference, pathway analysis, literature and patent intelligence, and aging-relevant target scoring. In the Nature Biotechnology paper, TNIK was reported as the top-ranked candidate in the protein and receptor kinase discovery scenario, representing a previously underexplored target class for IPF compared with the receptor tyrosine kinase biology addressed by existing antifibrotic drugs. Rentosertib also reflects Insilico's long-running thesis that aging biology can serve as a discovery engine for diseases of aging. In Aging, Insilico and collaborators described a hallmarks-of-aging-based strategy for identifying dual-purpose disease and age-associated targets using PandaOmics. The approach proposed that targets implicated in multiple hallmarks of aging, inflammation, extracellular matrix remodeling and age-related disease mechanisms could provide a route to therapeutics that address both disease pathology and aging-associated biology. This thesis was later highlighted in Nature Aging in the research highlight "Drug discovery by AI trained on aging biology", which described Insilico's use of PandaOmics to analyze multi-omics IPF datasets, biological networks and scientific literature, and to apply hallmarks-of-aging assessment in the prioritization of fibrosis targets. The highlight described TNIK as a top candidate emerging from an AI system built to connect disease biology with aging-relevant mechanisms. The aging-related rationale for TNIK inhibition has continued to develop. In Aging and Disease, Insilico and collaborators reported that pharmacological TNIK inhibition showed senomorphic activity in cellular senescence models using an AI-driven automated laboratory. The study identified TNIK inhibition as a potent senomorphic strategy and reported reductions in aging-related markers including senescence-associated secretory phenotype (SASP) and extracellular matrix remodeling signals across senescence models. These findings do not establish Rentosertib as an anti-aging therapy, but they strengthen the scientific rationale for investigating TNIK at the intersection of fibrosis, inflammation, senescence and age-related disease biology. The discovery and early development of Rentosertib were described in the Nature Biotechnology paper "A small-molecule TNIK inhibitor targets fibrosis in preclinical and clinical models". The paper reported the application of PandaOmics for fibrosis target discovery, the identification of TNIK as an AI-prioritized target, Chemistry42-driven small-molecule design and optimization, anti-fibrotic activity in preclinical models, and Phase I clinical evidence supporting safety, tolerability and pharmacokinetics in humans. The medicinal chemistry foundation of the program was further described in the Journal of Medicinal Chemistry paper "Discovery of Bis-imidazolecarboxamide Derivatives as Novel, Potent, and Selective TNIK Inhibitors for the Treatment of Idiopathic Pulmonary Fibrosis". The paper reported the discovery of novel TNIK inhibitor chemotypes and structure-guided medicinal chemistry, including structural support from the TNIK kinase domain co-crystal structure. Together, the Nature Biotechnology and Journal of Medicinal Chemistry papers provide unusually detailed peer-reviewed documentation for an AI-originated clinical-stage program: not only the platform narrative, but the target biology, chemistry, pharmacology and translational package. In 2025, Nature Medicine published Phase IIa results in the paper "A generative AI-discovered TNIK inhibitor for idiopathic pulmonary fibrosis: a randomized phase 2a trial". The GENESIS-IPF trial was a multicenter, double-blind, randomized, placebo-controlled Phase IIa study in 71 patients with IPF across 22 sites in China.