Tretinoin

drug
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Also known as AberelActicinAll-trans retinoic acidAll-trans-retinoic acidAltrenoAtralinAvitaEudynaKerlocalNSC-122758Oristar rnaRenovaRetin aRetin-aRetin-a microRetin-a-microRetinoic acidTretinoin component of solageTretinoin component of tri-luma

Summary

Tretinoin (CHEMBL38) is an approved small-molecule keratolytic drug (ATC D10AD51) targeting RARA, RARB, and RARG; indicated across 45 conditions including acne and neoplasm; with CIViC clinical evidence for 12 variant-indication associations (e.g. PML::RARA Fusion in acute promyelocytic leukemia).

At a glance

  • Status: Approved (max clinical phase 4)
  • Modality: Small molecule
  • ATC class: D10AD51 (+2 more)
  • Targets: 7 (RARA, RARB, RARG…)
  • Indications: 45 conditions
  • Clinical trials: 154
  • Precision-oncology evidence (CIViC): 12 variant–indication associations
  • Chemistry: 300.4 Da · C20H28O2

Identifiers

Drug identity and classification

FieldValue
ChEMBL IDCHEMBL38
NameTretinoin
TypeSmall molecule
Max phase4
FDA approvedyes
PubChem CID444795
ChEBICHEBI:15367
ATCD10AD51, L01XF01, D10AD01
Molecular formulaC20H28O2
Molecular weight300.4
InChIKeySHGAZHPCJJPHSC-YCNIQYBTSA-N

SMILES: CC1=C(C(CCC1)(C)C)/C=C/C(=C/C=C/C(=C/C(=O)O)/C)/C

IUPAC name: (2E,4E,6E,8E)-3,7-dimethyl-9-(2,6,6-trimethylcyclohexen-1-yl)nona-2,4,6,8-tetraenoic acid

ChEBI definition: A retinoic acid in which all four exocyclic double bonds have E- (trans-) geometry.

Pharmacological roles (ChEBI): keratolytic drug, antineoplastic agent, antioxidant, signalling molecule, retinoid X receptor agonist, anti-inflammatory agent, AP-1 antagonist, retinoic acid receptor agonist.

Other ChEBI roles (chemical / environmental): human metabolite.

Also known as: Aberel, Acticin, All-trans retinoic acid, All-trans-retinoic acid, Altreno, Atralin, Avita, Eudyna, Kerlocal, NSC-122758, Oristar rna, Renova

Parent form; salt/anhydrous children: CHEMBL2051965

Patent coverage: 55,679 distinct patent families (194,008 SureChEMBL compound mentions), from 1 matched compound structure(s). Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

GeneTargetActionpAffinityCancer dependencyUniProt
RARARetinoic acid receptor-αAgonist7.770.8%P10276
RARBRetinoic acid receptor-βAgonist9.40.1%P10826
RARGRetinoic acid receptor-γAgonist9.61.6%P13631
PPARDPeroxisome proliferator-activated receptor-β/δFull agonist7.80.6%Q03181
RORBRAR-related orphan receptor-βAgonist0.1%Q92753
NR2C2Testicular receptor 4Full agonist4.621.1%P49116
NR2E1TLXAgonist5.740.5%Q9Y466

Broader ChEMBL bioactivity targets: 51 (assay-derived). Sample: Microtubule-associated protein tau, Lysine-specific demethylase 4E, Nuclear receptor ROR-gamma, Survival motor neuron protein, ATP-dependent DNA helicase Q1, RecQ-like DNA helicase BLM, 4’-phosphopantetheinyl transferase ffp, Ferritin light chain, Geminin, Nuclear receptor ROR-gamma.

Bioactivity

ChEMBL activities: 237 potent at pChembl ≥ 5 of 265 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

TargetpChemblTypeValueUnitActivity ID
RARG10.4Ki0.04nMCHEMBL_ACT_657655
RARA10Ki0.1nMCHEMBL_ACT_194095
RORB9.82IC500.15nMCHEMBL_ACT_14551303
RARG9.7Kd0.2nMCHEMBL_ACT_1612380
RARG9.7EC500.2nMCHEMBL_ACT_2616029
P189119.66EC500.22nMCHEMBL_ACT_18488910
RARG9.52Kd0.3nMCHEMBL_ACT_755979
RARB9.4Ki0.4nMCHEMBL_ACT_194093
P629659.4Kd0.4nMCHEMBL_ACT_347449
RXRA9.4Ki0.4nMCHEMBL_ACT_663250
RARB9.4Kd0.4nMCHEMBL_ACT_755978
P629659.4Kd0.4nMCHEMBL_ACT_895116
RARB9.3Ki0.5nMCHEMBL_ACT_194092
RARG9.3EC500.5nMCHEMBL_ACT_207165
RARG9.3EC500.5nMCHEMBL_ACT_295012
RARG9.3EC500.5nMCHEMBL_ACT_324972
RARG9.3IC500.5nMCHEMBL_ACT_379663
RARG9.3EC500.5nMCHEMBL_ACT_499179
RXRB9.3Ki0.5nMCHEMBL_ACT_663251
RARG9.3Ki0.5nMCHEMBL_ACT_809836
P226059.28EC500.52nMCHEMBL_ACT_18488961
P189119.22EC500.6nMCHEMBL_ACT_19252171
RARG9.22Ki0.6nMCHEMBL_ACT_194096
RARG9.21IC500.62nMCHEMBL_ACT_41941
RARG9.15EC500.7nMCHEMBL_ACT_580466
RARG9.15Ki0.7nMCHEMBL_ACT_75533
RARG9.15EC500.7nMCHEMBL_ACT_854885
RARA9.11IC500.78nMCHEMBL_ACT_379661
RARB9.05IC500.9nMCHEMBL_ACT_379662
RARA9.05IC500.89nMCHEMBL_ACT_41939

Target pathways

Aggregated over 7 target gene(s): RARA, RARB, RARG, PPARD, RORB, NR2C2, NR2E1.

Top Reactome pathways

13 total, by targets touching each:

PathwayTargetsGenes
Nuclear Receptor transcription pathway7NR2C2, NR2E1, PPARD, RARA, RARB, RARG, RORB
Signaling by Retinoic Acid4PPARD, RARA, RARB, RARG
Activation of anterior HOX genes in hindbrain development during early embryogenesis3RARA, RARB, RARG
Carnitine shuttle1PPARD
Generic Transcription Pathway1RORB
SUMOylation of intracellular receptors1RARA
RNA Polymerase II Transcription1RORB
Gene expression (Transcription)1RORB
Regulation of PTEN gene transcription1NR2E1
Transcriptional regulation of granulopoiesis1RARA
TGFBR3 expression1RARA
Expression of BMAL (ARNTL), CLOCK, and NPAS21RORB
Interaction of NuRD complexes with transcription factors1NR2C2

Dominant GO biological processes

GO termTargets
positive regulation of transcription by RNA polymerase II7
regulation of DNA-templated transcription7
negative regulation of transcription by RNA polymerase II6
cell differentiation6
negative regulation of apoptotic process4
apoptotic process4
cell population proliferation4
intracellular receptor signaling pathway4
glandular epithelial cell development3
growth plate cartilage development3
positive regulation of cell population proliferation3
regulation of myelination3
multicellular organism growth3
negative regulation of DNA-templated transcription3
positive regulation of DNA-templated transcription3

Indications & clinical

Indications

45 indications (5 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

IndicationTrial phaseMONDOEFO
acne4MONDO:0011438EFO:0003894
neoplasm4MONDO:0005070EFO:0000616
acute promyelocytic leukemia4MONDO:0012883EFO:0000224
acute myeloid leukemia3MONDO:0018874EFO:0000222
rosacea3MONDO:0006604EFO:1000760
myelodysplastic syndrome3MONDO:0018881EFO:0000198
leukemia3MONDO:0005059EFO:0000565
squamous cell carcinoma3MONDO:0005096EFO:0000707
non-small cell lung carcinoma3MONDO:0005233EFO:0003060
basal cell carcinoma3MONDO:0020804EFO:0004193
autoimmune thrombocytopenic purpura3MONDO:0008558EFO:0007160
breast neoplasm3MONDO:0021100EFO:0003869
skin neoplasm3MONDO:0002531EFO:0004198
lymphoma2MONDO:0005062EFO:0000574
plasma cell myeloma2MONDO:0009693EFO:0001378
cutaneous melanoma2MONDO:0005012EFO:0000389
neuroblastoma2MONDO:0005072EFO:0000621
small cell lung carcinoma2MONDO:0008433EFO:0000702
melanoma2MONDO:0005105EFO:0000756
actinic keratosis2MONDO:0005173EFO:0002496
sclerosing cholangitis2MONDO:0018646EFO:0004268
anti-neutrophil antibody associated vasculitis2MONDO:0005435EFO:0004826
adenoid cystic carcinoma2MONDO:0004971EFO:0000231
prostate adenocarcinoma2MONDO:0005082EFO:0000673
pulmonary emphysema2MONDO:0004849EFO:0000464
exocrine pancreatic carcinoma2MONDO:0005192EFO:0002618
anemia2MONDO:0002280MONDO:0002280
kidney cancer2MONDO:0002367MONDO:0002367
lung neoplasm2MONDO:0021117MONDO:0008903
severe acute respiratory syndrome2MONDO:0005091MONDO:0100096
colorectal neoplasm2MONDO:0005335MONDO:0005575
hematopoietic and lymphoid system neoplasm1MONDO:0002334MONDO:0044881
myelodysplastic/myeloproliferative disease1MONDO:0020077MONDO:0020077
amyotrophic lateral sclerosis1MONDO:0004976MONDO:0004976
plasma cell neoplasm1MONDO:0004959EFO:0000200
glioblastoma1MONDO:0018177EFO:0000519
autism0MONDO:0005260EFO:0003758

8 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 154.

Phase distribution

PhaseTrials
PHASE259
PHASE328
Not specified15
PHASE1/PHASE214
PHASE114
PHASE411
PHASE2/PHASE37
EARLY_PHASE16

Top trials by phase / activity

NCTPhaseStatusTitle
NCT00408278PHASE4COMPLETEDTreatment of Newly Diagnosed Patients With Acute Promyelocytic Leukemia (PETHEMA LPA 2005)
NCT00504764PHASE4COMPLETEDTreatment of Relapsed Promyelocytic Leukemia With Arsenic Trioxide (ATO)
NCT00835198PHASE4COMPLETEDDapsone Gel 5% and Tretinoin Gel 0.025% Versus Tretinoin Gel 0.025% Monotherapy for Facial Acne Vulgaris
NCT01047189PHASE4COMPLETEDAdherence to Study Medication Compared to Generic Topical Clindamycin Plus Generic Topical Tretinoin in Subjects With Mild to Moderate Acne Vulgaris
NCT01206348PHASE4COMPLETEDCombination Treatment for Moderate to Severe Acne
NCT01987297PHASE4UNKNOWNCombined Retinoic Acid,Arsenic Trioxide and Chemo for Newly-diagnosed APL
NCT02020161PHASE4UNKNOWNClinical Guidelines for APL Treatment
NCT02200978PHASE4COMPLETEDA Study for Improving the Outcome of Childhood Acute Promyeloid Leukemia
NCT04096742PHASE4UNKNOWNAltreno for Chest Rejuvenation
NCT04548349PHASE4COMPLETEDProfiling the Skin Microbiome in Response to Altreno in Acne Patients
NCT07012811PHASE4COMPLETEDTreatment of Plane Warts With Topical and Oral Retinoids
NCT02339740PHASE3ACTIVE_NOT_RECRUITINGTretinoin and Arsenic Trioxide in Treating Patients With Untreated Acute Promyelocytic Leukemia
NCT06706401PHASE3RECRUITINGLymphocyte-Sparing And Radio-Immunotherapy in Head and Neck Carcinoma
NCT06787222PHASE2/PHASE3ACTIVE_NOT_RECRUITINGEffectiveness and Safety of Zingiber Officinale Transdermal Patch for Acne Vulgaris; Study of Interleukin 1 and Skin Microbiome
NCT07278908PHASE2/PHASE3NOT_YET_RECRUITINGAvatrombopag Combined With All-trans Retinoic Acid in the Treatment of Primary Immune Thrombocytopenia
NCT07503730PHASE3RECRUITINGEarly Use of Realgar-Indigo Naturalis Formula (RIF) Combined With All-trans Retinoic Acid (ATRA) for Treating Acute Promyelocytic Leukemia (APL).
NCT07504458PHASE3RECRUITINGPivotal Open-label Phase 3 Clinical Study of QTX-2101 in Adult Patients With Acute Promyelocytic Leukemia
NCT00002658PHASE3UNKNOWNCombination Chemotherapy, Biological Therapy, and Bone Marrow Transplantation in Treating Patients With Acute Myeloid Leukemia
NCT00002701PHASE3UNKNOWNCombination Chemotherapy With or Without Bone Marrow Transplantation in Treating Patients With Acute Promyelocytic Leukemia
NCT00003934PHASE3COMPLETEDTretinoin, Cytarabine, and Daunorubicin Hydrochloride With or Without Arsenic Trioxide Followed by Tretinoin With or Without Mercaptopurine and Methotrexate in Treating Patients With Acute Promyelocytic Leukemia
NCT00005823PHASE3COMPLETEDIntensive Compared With Nonintensive Chemotherapy in Treating Older Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome
NCT00005863PHASE3COMPLETEDCombination Chemotherapy With or Without Filgrastim and/or Tretinoin in Treating Patients With Acute Myeloid Leukemia
NCT00007631PHASE3COMPLETEDDetermine the Efficacy of Topical Tretinoin Cream for the Prevention of Nonmelanoma Skin Cancer
NCT00151242PHASE2/PHASE3COMPLETEDStudy on All-Trans Retinoic Acid, Induction and Consolidation Therapy, and Pegfilgrastim After Consolidation Therapy in Younger Patients With Newly Diagnosed Acute Myeloid Leukemia
NCT00151255PHASE3COMPLETEDAll-Trans Retinoic Acid in Combination With Standard Induction and Consolidation Therapy in Older Patients With Newly Diagnosed Acute Myeloid Leukemia
NCT00378365PHASE3UNKNOWNAcute Promyelocytic Leukemia 2006 (APL)
NCT00482833PHASE3COMPLETEDPhase III Trial in Acute Promyelocytic Leukemia Patients
NCT00492856PHASE3COMPLETEDS0521, Combination Chemotherapy With or Without Gemtuzumab Followed By Tretinoin, Mercaptopurine, and Methotrexate or Observation in Treating Patients With Acute Promyelocytic Leukemia
NCT00599937PHASE3COMPLETEDAPL93: Timing of CxT and Role of Maintenance
NCT00647556PHASE3COMPLETEDAdapalene Gel 0.3% Versus Tretinoin 0.05% Emollient Cream for Treatment of Photodamage
NCT00717652PHASE2/PHASE3SUSPENDEDEfficiency And Safety Of Association Arbutin, Triamcinolone And Tretinoin In Treatment Of Melasma
NCT00866918PHASE3COMPLETEDCombination Chemotherapy in Treating Young Patients With Newly Diagnosed Acute Promyelocytic Leukemia
NCT01041833PHASE3UNKNOWNEffect of All-trans Retinoic Acid With Chemotherapy Based on Paclitaxel and Cisplatin As First-line Treatment of Patients With Advanced Non-small Cell Lung Cancer and Expression of RAR-alfa and RAR-beta as Response Biomarker
NCT01067274PHASE3WITHDRAWNALFA-0703 Study in Older Patients With Acute Myeloblastic Leukemia (AML)
NCT01226303PHASE3UNKNOWNTreatment Study for Children and Adolescents With Acute Promyelocitic Leukemia
NCT01243450PHASE3COMPLETEDBioequivalence Study of Generic Tretinoin 0.04% Microsphere Gel, 0.04% Retin-A Micro® and Placebo
NCT01406080PHASE3COMPLETEDA Comparative Study of Adapalene Gel,0.3% Versus Tretinoin Emollient Cream, 0.05% for the Treatment of Photoaging
NCT02249767PHASE3COMPLETEDBioequivalence Study of Tretinoin Gel 0.05% to Brand Tretinoin Gel
NCT02688140PHASE3COMPLETEDStudy for Patients With Newly Diagnosed, High-risk Acute Promyelocytic Leukemia
NCT02899169PHASE3UNKNOWNTreatment of Non-high-risk Acute Promyelocytic Leukemia (APL) With Realgar-Indigo Naturalis Formula (RIF)

Clinical evidence (CIViC)

Variant × indication × effect (12 predictive associations from 14 curated evidence items):

VariantIndicationEffectTherapyLevelCIViC
PML::RARA FusionAcute Promyelocytic LeukemiaSensitivity/ResponseArsenic Trioxide + TretinoinCIViC AEID1091
NPM1 EXON 11 MUTATIONAcute Myeloid LeukemiaSensitivity/ResponseTretinoinCIViC BEID137 +1
PML::RARA FusionAcute Promyelocytic LeukemiaSensitivity/ResponseTretinoinCIViC BEID316 +1
CEBPA MutationAcute Myeloid LeukemiaSensitivity/ResponseTretinoinCIViC BEID122
FLT3 ITDAcute Promyelocytic LeukemiaResistanceAnthracycline Antineoplastic Antibiotic + TretinoinCIViC BEID1112
FLT3 ITDAcute Myeloid LeukemiaResistanceTretinoinCIViC BEID127
PML B2 DOMAIN MUTATIONAcute Promyelocytic LeukemiaResistanceTretinoinCIViC BEID1092
PML K227_T233delAcute Promyelocytic LeukemiaResistanceTamibarotene + TretinoinCIViC CEID8175
PML::RARA Fusion AND PML A216VAcute Promyelocytic LeukemiaResistanceTretinoinCIViC CEID1093
PML::RARA Fusion AND PML L218PAcute Promyelocytic LeukemiaResistanceTretinoinCIViC CEID1094
ALDH1A2 UnderexpressionHead And Neck Squamous Cell CarcinomaSensitivity/ResponseTretinoinCIViC DEID1115
NPM1 EXON 11 MUTATIONAcute Myeloid LeukemiaSensitivity/ResponseNSC348884 + TretinoinCIViC DEID149

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline or drug-level clinical/variant annotations in PharmGKB for this molecule.

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

72 molecules share ≥1 primary target. Top 60 by shared-target count:

MoleculeSourceStatusShared targets
RosiglitazoneChEMBL + PubChemPhase 4 (approved)PPARD, RARA, RARB, RARG
SunitinibPubChemApprovedNR2C2, RARA, RARB, RARG
AcetaminophenChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
ADAPALENEChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
ALITRETINOINChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
AlprostadilChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
AmoxicillinChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
BEXAROTENEChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
cyclosporineChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
OlanzapineChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
REGORAFENIBChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
TAZAROTENEChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
TolcaponeChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
TRIFAROTENEChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
ZafirlukastChEMBL + PubChemPhase 4 (approved)RARA, RARB, RARG
TAMIBAROTENEChEMBLPhase 4 (approved)RARA, RARB, RARG
CONESSINEChEMBLPhase 2RARA, RARB, RARG
GLIQUIDONEChEMBLPhase 2RARA, RARB, RARG
AtorvastatinPubChemApprovedRARA, RARB, RARG
BosentanPubChemApprovedRARA, RARB, RARG
CalcitriolPubChemApprovedRARA, RARB, RARG
CarprofenPubChemApprovedRARA, RARB, RARG
DiclofenacPubChemApprovedRARA, RARB, RARG
ethinyl estradiolPubChemApprovedRARA, RARB, RARG
RepaglinidePubChemApprovedRARA, RARB, RARG
rifampinPubChemApprovedRARA, RARB, RARG
SimvastatinPubChemApprovedRARA, RARB, RARG
TiclopidinePubChemApprovedRARA, RARB, RARG
VerapamilPubChemApprovedRARA, RARB, RARG
TROGLITAZONEChEMBLPhase 4 (approved)RARB, RARG
RetinolPubChemApprovedNR2C2, RARA
RivaroxabanPubChemApprovedRARB, RARG
CAFFEINEChEMBL + PubChemPhase 4 (approved)NR2E1
PROPAFENONEChEMBL + PubChemPhase 4 (approved)NR2E1
PROPRANOLOLChEMBL + PubChemPhase 4 (approved)NR2E1
SELADELPARChEMBL + PubChemPhase 4 (approved)PPARD
TADALAFILChEMBL + PubChemPhase 4 (approved)NR2E1
BERBERINEChEMBLPhase 4 (approved)PPARD
ELAFIBRANORChEMBLPhase 4 (approved)PPARD
IBUPROFENChEMBLPhase 4 (approved)RARB
KETOCONAZOLEChEMBLPhase 4 (approved)RARB
PEMAFIBRATEChEMBLPhase 4 (approved)PPARD
PIOGLITAZONEChEMBLPhase 4 (approved)PPARD
RACECADOTRILChEMBLPhase 4 (approved)RARG
TROVAFLOXACINChEMBLPhase 4 (approved)RARB
ALEGLITAZARChEMBLPhase 3PPARD
BEZAFIBRATEChEMBLPhase 3PPARD
GAMOLENIC ACIDChEMBLPhase 3PPARD
ICOSAPENTChEMBLPhase 3PPARD
LANIFIBRANORChEMBLPhase 3PPARD
NAMODENOSONChEMBLPhase 3PPARD
CEP-11981ChEMBLPhase 2NR2C2
DEXPROPRANOLOLChEMBLPhase 2NR2E1
DIHOMO-GAMMA-LINOLENIC ACIDChEMBLPhase 2PPARD
FARGLITAZARChEMBLPhase 2PPARD
GW501516ChEMBLPhase 2PPARD
GW590735ChEMBLPhase 2PPARD
INDEGLITAZARChEMBLPhase 2PPARD
LEVOPROPRANOLOLChEMBLPhase 2NR2E1
LINOLEIC ACIDChEMBLPhase 2PPARD