Insilico Medicine's Alex Zhavoronkov bets China and AI can deliver the drug industry's next breakthrough

Summary

Alex Zhavoronkov, co-CEO of the AI drug discovery startup Insilico Medicine, dresses the same way at all his public engagements: a black padded vest with a small white badge that keeps count of the company’s clinical pipeline. When Fortune sat down with him in Hong Kong in July, he made sure to point out the badge’s latest revision: a small circle beside “Phase 3.” The badge is a provocation as much as a point of pride. “My China team loves it,” he said. “In other geographies, they absolutely hate it, because displaying something like this means you have to compete.” Just a few days earlier, Insilico had announced that rentosertib, its drug for idiopathic pulmonary fibrosis, a fatal lung-scarring disease that leads to breathlessness and coughing, would start Phase 3 trials in China. Insilico used AI to both identify the disease target and develop the molecule to treat it; it claims it’s the first such AI-discovered drug to make it to large-scale clinical trials. (The first patient in the trial was dosed on Sept. 10.) The news has only kept building from there. On Sept. 7, Insilico published a study in Nature Biotechnology reporting that some blood samples from 42 rentosertib patients showed signs of reversed biological age. Insilico executives cautioned that the effect is small, and may not be sustained over a longer period of time. Yet it’s still among the first clinical hints that a drug invented by AI might slow, or even reverse, aging. “We believe aging is related to fibrosis. When people get old, there’s more and more fibrosis happening,” co-CEO Feng Ren told the Fortune Leaders Forum in Macau on Sept. 8, the day after the study’s publication. (Fibrosis refers to an excessive buildup of scar tissue). “ If we can stop the fibrosis, then we might have a chance to stop biological aging.” Insilico is also trying to shape how AI’s usefulness in longevity research gets measured. On Sept. 17, it launched LongevityBench, a test of large language models’ grasp of aging biology; in a study featured on the cover of Cell, the company said smaller, aging-trained models beat several frontier systems on the new metric. That leaves Insilico running the drug industry’s most consequential experiment–or, more accurately, three of them. First, whether an AI-discovered molecule can survive a Phase 3 trial; second, whether AI drug discovery can make money; and finally, whet…