Polyploid giant cancer cells (PGCCs) have been observed in epithelial ovarian tumors and have the ability to survive to antimitotic drugs. Their appearance can result from paclitaxel treatment or hypoxia, two conditions known to induce unfolded protein response (UPR) activation. PGCCs produced under hypoxia may be formed by cell fusion and can contribute by bursting and budding to the generation of cancer stem-like cells which have a more aggressive phenotype than the parental cells. Despite the fact that PGCCs may contribute to tumor maintenance and recurrence, they were poorly studied. Here, we confirmed that PGCCs could derive, at least in part, from cell fusion. We also observed that PGCCs nuclei were able to fuse. The resulting cells were able to proliferate by mitosis and were more invasive than the parental cancer cells. Using two different ovarian cancer cell lines (COV318 and SKOV3), we showed that UPR activation with chemical inducers increased cell fusion and PGCCs appearance. Down-regulation of the UPR-associated protein PERK expression partially reversed the UPR-induced PGCCs formation, suggesting that the PERK arm of the UPR is involved in ovarian PGCCs onset. Keywords: ER stress; unfolded protein response; ovarian cancer; PGCC; cell fusion; nuclei fusion; invasion large cells containing several copies of DNA and positive for cancer stem cell markers [10]. Interestingly, the presence of PGCCs in ovarian cancer has been reported preferentially at late disease stages and in high pathological grades [10]. We previously showed that primary EOC cells isolated from malignant ascites were able to spontaneously form PGCCs in culture [11]. However, the origin of PGCCs is controversial since both fusion or endoreplication processes could give rise to them [8,9,12]. Zhang et al., demonstrated that in SKOV3, an EOC cell line established from ascites, the formation of PGCCs was at least partially due to cell fusion events [9]. In the study conducted by Zhang et al., the PGCCs derived from EOC cells had striking properties such as different cell cycle regulation and division profile, changing their daughter generation mechanism from mitosis to budding, which confer these cells the resistance to cytotoxic chemotherapy treatments [9]. Additionally, it was found that hypoxia increased PGCCs formation [9,[13][14][15], but other conditions such as chemotherapy could also favor their production [13].The tumor environment is known to be hypoxic and hypoglycemic due to the low irrigation caused by the fast and erroneous angiogenesis that tumor mass undergo [reviewed at [16]]. These conditions are capable of triggering the endoplasmic reticulum stress (ERS) response or unfolded protein response (UPR) which is essential for cellular adaptation to stressful situations [17]. In homeostatic conditions, the three UPR-associated proteins, protein kinase RNA-like endoplasmic reticulum kinase (PERK), inositol-requiring enzyme 1α (IRE1α) and activating transcription factor 6 (ATF6), remain inactive because of their binding with Gl...