MIS reduced colony formation and proliferation rate of human ovarian cancer stem cells by inducing G1 cell cycle arrest and increasing cell cycle inhibitors compared with doxorubicin. (A–C) 3+Ecad− and 3−Ecad+ cells isolated from OVCAR-5 by FACS were plated at 2,000 cells/well in six-well plates and treated with MIS (50 μg/mL) or doxorubicin (30 nM) or media (as a control) for 14 d. The area stained with Giemsa (A and B) was equated to colony formation (C) (20). The colony area formed by 3+Ecad− cells was greater than that formed by 3−Ecad+ cells (A and B, controls, and Fig. S5). MIS treatment inhibited colony formation (A, Upper, and C; **P < 0.01) of the 3+Ecad− cells compared with doxorubicin (B, Upper, and C) (n = 3 separate experiments). (D) OVCAR-5 cells were plated at 1.6, 1.2, or 0.8 × 106 cells in T75 flasks (n = 3 for each cell number) and treated with doxorubicin (60 nM) for 1, 2, and 3 d. Doxorubicin treatment inhibits proliferation of total viable cells (D, Left) and 3−Ecad+ population (D, Right), but stimulates that of the 3+Ecad− population (D, Center). (E and F) In OVCAR-5 cell cycle analysis, MIS increased the 3+Ecad− cells in G1 (E, Left), whereas doxorubicin decreased 3+Ecad− in G1 (E, Right) (n = 3; **P < 0.01). Neither MIS nor doxorubicin affected the G1 distribution of the 3−Ecad+ population (F). (G) MOVCAR-7 and MOVCAR-8 cell lines were treated with 50 μg/mL of MIS, 60 nM of doxorubicin, or vehicle control for 4 h. MIS increased p15 expression in MOVCAR-7 and -8 (**P < 0.01); conversely, doxorubicin decreased p15 expression in MOVCAR-7 and -8 (*P < 0.05).