TY - JOUR KW - drug safety KW - Preclinical research AU - Christopher E. Goldring AU - Giusy Russomanno AU - Carmen Pin AU - Panuwat Trairatphisan AU - Kylie A. Beattie AU - Ciarán P. Fisher AU - Janet Piñero AU - Richard J. Brennan AU - Diana Clausznitzer AU - Ian M. Copple AU - Theo M. de Kok AU - Carrie A. Duckworth AU - Laura I. Furlong AU - Barbara Füzi AU - Attila Gabor AU - Louis Gall AU - Jan Hengstler AU - Henning Hermjakob AU - Fiona Hunter AU - Danyel Jennen AU - Mikko Koskinen AU - Steven J. Kunnen AU - Lieve Lammens AU - Sebastian Lobentanzer AU - Marcel Mohr AU - Elisa Passini AU - D. Mark Pritchard AU - Rahuman S. Malik-Sheriff AU - Blanca Rodriguez AU - Eric I. Rossman AU - Julio Saez-Rodriguez AU - Friedemann Schmidt AU - Rowena Sison-Young AU - Inari Soininen AU - Sean Turner AU - Bob van de Water AU - Johan G. C. van Hasselt AU - Filippo Venezia AU - Jeffrey A. Willy AU - Derek J. Leishman AU - James L. Stevens AU - Loic Laplanche AB - Reliable prediction and prevention of adverse drug reactions (ADRs) remains a key challenge in the development of new medicines. Advanced mathematical and computational modelling approaches, which incorporate cutting-edge mechanistic understanding of ADRs in concert with systematically collected data addressing knowledge gaps, are integral components of model-informed drug discovery and development (MID3). These approaches provide a precise, quantitative framework for predicting and mitigating safety risks in the earliest phases of drug development. Here, we highlight recent developments in the burgeoning field of quantitative systems toxicology (QST), including insights into the current state-of-the-art, as well as outcomes from the Innovative Medicines Initiative (IMI) 2 TransQST project. QST models that describe the disruption of cardiovascular, gastrointestinal, hepatic and renal physiological functions following drug exposure are presented, along with recommendations for their application in drug discovery and development. BT - Nature Reviews Drug Discovery DA - 2025-10-27 DO - 10.1038/s41573-025-01308-z LA - en N2 - Reliable prediction and prevention of adverse drug reactions (ADRs) remains a key challenge in the development of new medicines. Advanced mathematical and computational modelling approaches, which incorporate cutting-edge mechanistic understanding of ADRs in concert with systematically collected data addressing knowledge gaps, are integral components of model-informed drug discovery and development (MID3). These approaches provide a precise, quantitative framework for predicting and mitigating safety risks in the earliest phases of drug development. Here, we highlight recent developments in the burgeoning field of quantitative systems toxicology (QST), including insights into the current state-of-the-art, as well as outcomes from the Innovative Medicines Initiative (IMI) 2 TransQST project. QST models that describe the disruption of cardiovascular, gastrointestinal, hepatic and renal physiological functions following drug exposure are presented, along with recommendations for their application in drug discovery and development. PY - 2025 SP - 1 EP - 16 ST - Quantitative systems toxicology T2 - Nature Reviews Drug Discovery TI - Quantitative systems toxicology: modelling to mechanistically understand and predict drug safety UR - https://www.nature.com/articles/s41573-025-01308-z Y2 - 2025-11-06 SN - 1474-1784 ER -