# Selective inhibition of ALDH1A3 impedes breast cancer growth and metastasis by blocking ALDH1A3-driven transcriptional programs

**Authors:** Maya R. MacLean, Bianca Laura Bernardoni, Wasundara Fernando, Giovanni Petrarolo, Ilaria D’Agostino, Cheryl A. Dean, Jaganathan Venkatesh, Christopher S. Hughes, Kerry B. Goralski, Geetha Subramanian, Raj Pranap Arun, Hannah F. Cahill, Olivia L. Walker, Lynn N. Thomas, Robert C. Douglas, Concettina La Motta, Paola Marcato

PMC · DOI: 10.1016/j.isci.2026.114863 · 2026-01-31

## TL;DR

A new drug called CLM296 selectively blocks ALDH1A3, a protein linked to breast cancer growth and spread, showing promise in preclinical models.

## Contribution

Development of CLM296, a first-in-class selective ALDH1A3 inhibitor with demonstrated anti-cancer effects in triple-negative breast cancer.

## Key findings

- CLM296 inhibits ALDH1A3 with high potency (2 nM) and no off-target effects on ALDH1A1.
- CLM296 reduces ALDH1A3-driven tumor growth and metastasis in TNBC xenografts.
- Pharmacokinetic studies show CLM296 has favorable oral bioavailability and tissue distribution.

## Abstract

Aldehyde dehydrogenase 1A3 (ALDH1A3) promotes tumor growth, metastasis, and chemoresistance in multiple cancers, including triple-negative breast cancer (TNBC), yet no clinically approved, isoform-selective inhibitors exist. Here, we present CLM296, a novel, rationally designed, highly potent ALDH1A3 inhibitor. CLM296 exhibits nanomolar inhibition of ALDH1A3 in TNBC cells (half-maximal inhibitory concentration = 2 nM) with no off-target effects on ALDH1A1. Transcriptomic analysis shows that CLM296 selectively suppresses ALDH1A3-driven gene expression, confirming on-target activity. Functionally, CLM296 impedes ALDH1A3-mediated cell invasion in vitro and, with daily dosing in vivo, significantly reduces only ALDH1A3-dependent tumor growth and lung metastasis in TNBC xenografts. These effects are accompanied by selective inhibition of ALDH1A3 target genes in tumors, while pharmacokinetic studies demonstrate broad tissue distribution to metastatic sites, sustained target engagement, and favorable oral bioavailability. CLM296 shows no observable toxicity in preclinical models, supporting its potential as a first-in-class ALDH1A3 inhibitor for ALDH1A3-positive cancers.

•Novel small molecule, CLM296, is a highly potent ALDH1A3 inhibitor•Transcriptomic analysis reveals that CLM296 reverses ALDH1A3-driven gene programs•CLM296 specifically suppresses ALDH1A3-mediated breast tumor growth and metastasis•Pharmacokinetics show systemic distribution with possibility for once-daily dosing

Novel small molecule, CLM296, is a highly potent ALDH1A3 inhibitor

Transcriptomic analysis reveals that CLM296 reverses ALDH1A3-driven gene programs

CLM296 specifically suppresses ALDH1A3-mediated breast tumor growth and metastasis

Pharmacokinetics show systemic distribution with possibility for once-daily dosing

Molecular mechanism of gene regulation; Molecular interaction; Cancer

## Linked entities

- **Genes:** ALDH1A3 (aldehyde dehydrogenase 1 family member A3) [NCBI Gene 220], ALDH1A1 (aldehyde dehydrogenase 1 family member A1) [NCBI Gene 216]
- **Proteins:** ALDH1A3 (aldehyde dehydrogenase 1 family member A3)
- **Diseases:** triple-negative breast cancer (MONDO:0005494), breast cancer (MONDO:0004989)

## Full-text entities

- **Genes:** Il1a (interleukin 1 alpha) [NCBI Gene 16175] {aka Il-1a}, PLG (plasminogen) [NCBI Gene 5340] {aka HAE4}, Il1b (interleukin 1 beta) [NCBI Gene 16176] {aka IL-1beta, Il-1b}, ALDH5A1 (aldehyde dehydrogenase 5 family member A1) [NCBI Gene 7915] {aka SSADH, SSDH}, B2M (beta-2-microglobulin) [NCBI Gene 567] {aka AMYLD6, IMD43, MHC1D4}, Cdh1 (cadherin 1) [NCBI Gene 12550] {aka ARC-1, E-cad, Ecad, L-CAM, UVO, Um}, PTGES (prostaglandin E synthase) [NCBI Gene 9536] {aka MGST-IV, MGST1-L1, MGST1L1, MPGES, PGES, PIG12}, RARRES1 (retinoic acid receptor responder 1) [NCBI Gene 5918] {aka LXNL, PERG-1, TIG1}, MUC4 (mucin 4, cell surface associated) [NCBI Gene 4585] {aka ASGP, HSA276359, MUC-4}, Il24 (interleukin 24) [NCBI Gene 93672] {aka FISP, If2e, Mda-7, Mda7, St16}, ELF3 (E74 like ETS transcription factor 3) [NCBI Gene 1999] {aka EPR-1, ERT, ESE-1, ESX}, DHRS3 (dehydrogenase/reductase 3) [NCBI Gene 9249] {aka CNALPTC1, CRSS, DD83.1, RDH17, Rsdr1, SDR1}, CYP4X1 (cytochrome P450 family 4 subfamily X member 1) [NCBI Gene 260293] {aka CYPIVX1}, ALDH1B1 (aldehyde dehydrogenase 1 family member B1) [NCBI Gene 219] {aka ALDH5, ALDHX}, ARF1 (ARF GTPase 1) [NCBI Gene 375] {aka PVNH8}, ALDH3B1 (aldehyde dehydrogenase 3 family member B1) [NCBI Gene 221] {aka ALDH4, ALDH7}, Pdcd1 (programmed cell death 1) [NCBI Gene 18566] {aka Ly101, PD-1, Pdc1}, RPL29 (ribosomal protein L29) [NCBI Gene 6159] {aka HIP, HUMRPL29, L29, RPL29P10, RPL29_3_370, eL29}, ALDH1A3 (aldehyde dehydrogenase 1 family member A3) [NCBI Gene 220] {aka ALDH1A6, ALDH6, MCOP8, RALDH3}, GABRE (gamma-aminobutyric acid type A receptor subunit epsilon) [NCBI Gene 2564], CDH2 (cadherin 2) [NCBI Gene 1000] {aka ACOGS, ADHD8, ARVD14, CD325, CDHN, CDw325}, GDF15 (growth differentiation factor 15) [NCBI Gene 9518] {aka GDF-15, HG, MIC-1, MIC1, NAG-1, PDF}, RARB (retinoic acid receptor beta) [NCBI Gene 5915] {aka HAP, MCOPS12, NR1B2, RARbeta, RARbeta1, RRB2}, ALDH1A2 (aldehyde dehydrogenase 1 family member A2) [NCBI Gene 8854] {aka DIH4, RALDH(II), RALDH2, RALDH2-T}, ALDH1A1 (aldehyde dehydrogenase 1 family member A1) [NCBI Gene 216] {aka ALDC, ALDH-E1, ALDH1, ALDH11, HEL-9, HEL-S-53e}, EYA2 (EYA transcriptional coactivator and phosphatase 2) [NCBI Gene 2139] {aka EAB1}, Cdh2 (cadherin 2) [NCBI Gene 12558] {aka CDHN, N-CAD, Ncad}, ALDH3A1 (aldehyde dehydrogenase 3 family member A1) [NCBI Gene 218] {aka ALDH3, ALDHIII}, PUM1 (pumilio RNA binding family member 1) [NCBI Gene 9698] {aka HSPUM, NEDMSF, PUMH, PUMH1, PUML1, SCA47}, PLAT (plasminogen activator, tissue type) [NCBI Gene 5327] {aka T-PA, TPA}, ALDH2 (aldehyde dehydrogenase 2 family member) [NCBI Gene 217] {aka ALDH-E2, ALDHI, ALDM}, Aldh1a3 (aldehyde dehydrogenase family 1, subfamily A3) [NCBI Gene 56847] {aka ALDH6, RALDH3, V1}, ALDH3A2 (aldehyde dehydrogenase 3 family member A2) [NCBI Gene 224] {aka ALDH10, FALDH, SLS}, Gapdh (glyceraldehyde-3-phosphate dehydrogenase) [NCBI Gene 14433] {aka Gapd}, GAPDH (glyceraldehyde-3-phosphate dehydrogenase) [NCBI Gene 2597] {aka G3PD, GAPD, HEL-S-162eP}, TIMP3 (TIMP metallopeptidase inhibitor 3) [NCBI Gene 7078] {aka HSMRK222, K222, K222TA2, SFD}, Gpt (glutamic pyruvic transaminase, soluble) [NCBI Gene 76282] {aka 1300007J06Rik, 2310022B03Rik, ALT, ALT1, Gpt-1, Gpt1}, CDH1 (cadherin 1) [NCBI Gene 999] {aka Arc-1, BCDS1, CD324, CDHE, ECAD, LCAM}, Aldh1a1 (aldehyde dehydrogenase family 1, subfamily A1) [NCBI Gene 11668] {aka ALDH-E1, ALHDII, Ahd-2, Ahd2, Aldh1, Aldh1a2}, STRA6 (signaling receptor and transporter of retinol STRA6) [NCBI Gene 64220] {aka MCOPCB8, MCOPS9, PP14296, SLC69A1}, TBP (TATA-box binding protein) [NCBI Gene 6908] {aka GTF2D, GTF2D1, HDL4, SCA17, TBP1, TFIID}, TGM2 (transglutaminase 2) [NCBI Gene 7052] {aka G(h), TG(C), TGC, hTG2, tTG}, Rars1 (arginyl-tRNA synthetase 1) [NCBI Gene 104458] {aka 2610011N19Rik, 2610037E21Rik, Rars}
- **Diseases:** pancreatic cancer (MESH:D010190), inflammatory (MESH:D007249), melanoma (MESH:D008545), glioma (MESH:D005910), NOD (MESH:D020191), Cancer (MESH:D009369), MDA-MB-231 (OMIM:613675), gastric cancer (MESH:D013274), non-obese diabetic (MESH:D009765), SCID (MESH:D053632), melanoma, prostate, head and neck, and non-small cell lung cancers (MESH:D002289), non (MESH:C580335), acute myeloid leukemia (MESH:D015470), sarcoma (MESH:D012509), respiratory distress (MESH:D012128), triple (MESH:C536008), breast, glioma, (MESH:D061325), immunodeficient (MESH:D007153), leukemia (MESH:D007938), mycoplasma (MESH:D009175), breast, colorectal, gastric, and prostate cancers (MESH:D015179), lung metastasis (MESH:D009362), toxicities (MESH:D064420), hepatic or renal toxicity (MESH:D056486), gastric (MESH:D013272), breast and colorectal cancer (MESH:D001943), TNBC (MESH:D064726), glioblastoma (MESH:D005909), obese diabetic severe (MESH:D009767)
- **Chemicals:** formic acid (MESH:C030544), phosphate (MESH:D010710), paraffin (MESH:D010232), 3H (MESH:D014316), methanol (MESH:D000432), trypan blue (MESH:D014343), NaCl (MESH:D012965), sodium deoxycholate (MESH:D003840), 7-aminoactinomycin D (MESH:C025942), acetonitrile (MESH:C032159), Nonidet P-40 (MESH:C010615), EDTA (MESH:D004492), 2-bromoacetophenone (MESH:C013190), carboxylic acids (MESH:D002264), N2 (MESH:D009584), TRIzol (MESH:C411644), vitamin A (MESH:D014801), imidazo[1,2-a]pyridine (MESH:C001439), H2O (MESH:D014867), decitabine (MESH:D000077209), EtOH (MESH:D000431), Acrylamide (MESH:D020106), 13C (MESH:C000615229), aldehydes (MESH:D000447), GABA (MESH:D005680), all-trans-retinal (MESH:D012172), Laemmli buffer (MESH:C088816), ATRA (MESH:D014212), puromycin (MESH:D011691), 2H (MESH:D003903), 4-acetylphenylboronic acid (-), crystal violet (MESH:D005840), disulfiram (MESH:D004221), phenol red (MESH:D010637), H&amp;E (MESH:D006371), acetone (MESH:D000096), toluene (MESH:D014050), peroxide (MESH:D010545), Picrosirius red (MESH:C009798), indomethacin (MESH:D007213), Na2CO3 (MESH:C005686), luminol (MESH:D008165), CO2 (MESH:D002245), glucose (MESH:D005947), formalin (MESH:D005557), Creatinine (MESH:D003404), DMSO (MESH:D004121), nicotinamide adenine dinucleotide (MESH:D009243), Tween 20 (MESH:D011136), DP (MESH:D004176), DAB (MESH:C000469), hydrogen (MESH:D006859)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Homo sapiens (human, species) [taxon 9606]
- **Mutations:** C-220 C
- **Cell lines:** MDA-MB-468 — Homo sapiens (Human), Breast adenocarcinoma, Cancer cell line (CVCL_0419), HCC-1806 — Homo sapiens (Human), Breast acantholytic squamous cell carcinoma, Cancer cell line (CVCL_1258), MDA-MB-231 — Homo sapiens (Human), Breast adenocarcinoma, Cancer cell line (CVCL_0062), shControl — Callithrix jacchus (White-tufted-ear marmoset), Induced pluripotent stem cell (CVCL_A8XX), A375 — Homo sapiens (Human), Amelanotic melanoma, Cancer cell line (CVCL_0132)

## Figures

7 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12962171/full.md

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Source: https://tomesphere.com/paper/PMC12962171