(H) Schematic illustration shows that Nanog is a barrier for KL ADC to IMA transition. Notch signaling is up-regulated in IMA and promotes mucinous differentiation which could be reversed by γ-secretase inhibitor LY-411575. LY-411575 or Phenformin treatment has little effect on mucinous tumor progression. Combination therapy overcomes the treatment resistance imposed by mucinous lineage transition through induction of cell apoptosis. 