Some ovarian cancer cells in vivo are in a reversible quiescent state where they can contribute to cancer spread under favorable growth conditions. The serine/threonine kinase Mirk/dyrk1B was expressed in each of seven ovarian cancer cell lines and in 21 of 28 resected human ovarian cancers, and upregulated in 60% of the cancers. Some ovarian cancer cells were found in a G0 quiescent state, with the highest fraction in a line with an amplified Mirk gene. Suboptimal culture conditions increased the G0 fraction in SKOV3 and TOV21G, but not OVCAR4 cultures. Less than half as many OVCAR4 cells survived under suboptimal culture conditions as shown by total cell numbers, dye exclusion viability studies, and assay of cleaved apoptotic marker proteins. G0 arrest in TOV21G and SKOV3 cells led to increased levels of Mirk, the CDK inhibitor p27, p130/Rb2, and p130/Rb2 complexed with E2F4. The G0 arrest was transient, and cells exited G0 when fresh nutrients were supplied. Depletion of p130/Rb2 reduced the G0 fraction, increased cell sensitivity to serum-free culture and to cisplatin, and reduced Mirk levels. Mirk contributed to G0 arrest by destabilization of cyclin D1. In TOV21G cells, but not in normal diploid fibroblasts, Mirk depletion led to increased apoptosis and loss of viability. Because Mirk is expressed at low levels in most normal adult tissues, the elevated Mirk protein levels in ovarian cancers may present a novel therapeutic target, in particular for quiescent tumor cells which are difficult to eradicate by conventional therapies targeting dividing cells.Normal diploid cells such as lymphocytes and fibroblasts go into a reversible growth arrest called quiescence in response to anti-proliferative environmental signals. These normal cells maintain quiescence through upregulating the CDK inhibitor p27 in part through increasing the stability of the CDK inhibitor p27 through the kinase Mirk, 1-3 upregulate the transcriptional repressor HES1 to block senescence or differentiation, 4,5 and block apoptosis through several mechanisms. A subpopulation of tumor cells, possibly including stem cells, remains in a nondividing quiescent state that renders them relatively resistant to chemotherapy and radiation therapy which target dividing cells.6 By entering a quiescent state, tumor cells can resist the nutrient deficiencies, hypoxic and acidic conditions within the tumor mass. Mirk has also been reported by our group to maintain the viability of quiescent pancreatic cancer cells by reducing intracellular levels of reactive oxygen species (ROS). 7 Normal cells in quiescence activate pathways that protect them from metabolic stress, and a subpopulation of tumor cells is likely to utilize similar pathways to survive within the tumor microenvironment. The anti-apoptotic proteins BCL2 and BCL-XL have been shown to facilitate G0 quiescence in murine embryonic fibroblasts by decreasing RNA content and cell size, and by upregulating p27 protein through its stabilization following phosphorylation of p27Ser10 by Mirk. 3 Epit...