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H3B-120 is a selective, competitive, and allosteric small-molecule inhibitor of carbamoyl phosphate synthetase 1 (CPS1). Developed by H3 Biomedicine, H3B-120 binds to an allosteric pocket situated between the integrating and ATP A domains of CPS1, inducing a conformational change that blocks ATP binding and subsequent catalysis. CPS1 catalyzes the first step of the urea cycle, converting ammonia to carbamoyl phosphate. In certain cancers, such as MYC-driven medulloblastoma, LKB1-deficient non-small cell lung cancer (NSCLC), and other tumor types, CPS1 is overexpressed to support pyrimidine biosynthesis or prevent toxic ammonia accumulation. By inhibiting CPS1, H3B-120 impairs both the urea cycle and pyrimidine synthesis, demonstrating potential antitumor activity.
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