Human cancers are complex ecosystems composed of cells with distinct phenotypes, genotypes and epigenetic states, but current models do not adequately reflect tumor composition in patients. We used single cell RNA-seq to profile 430 cells from five primary glioblastomas, which we found to be inherently variable in their expression of diverse transcriptional programs related to oncogenic signaling, proliferation, complement/immune response and hypoxia. We also observed a continuum of stemness-related expression states that enabled us to identify putative regulators of stemness in vivo. Finally, we show that established glioblastoma subtype classifiers are variably expressed across individual cells within a tumor and demonstrate the potential prognostic implications of such intratumoral heterogeneity. Thus, we reveal previously unappreciated heterogeneity in diverse regulatory programs central to glioblastoma biology, prognosis, and therapy.Tumor heterogeneity poses a major challenge to cancer diagnosis and treatment. It can manifest as variability between tumors, wherein different stages, genetic lesions or * Corresponding authors: Bernstein.bradley@mgh.harvard.edu (BEB), aregev@broadinstitute.org (AR), Suva.Mario@mgh.harvard.edu (MLS). † These authors contributed equally to this work. ‡ These authors contributed equally to this work. Glioblastoma is an archetypal example of a heterogeneous cancer and one of the most lethal human malignancies (9, 10). Intratumoral heterogeneity and redundant signaling routes likely underlie the inability of conventional and targeted therapies to achieve long-term remissions (11-13). These tumors contain cellular niches enriched for distinct phenotypic properties, including transient quiescence and self-renewal (14-16), adaptation to hypoxia (17), and resistance to radiation induced DNA damage (18,19). DNA and RNA profiles of bulk tumors have enabled genetic and transcriptional classification of glioblastomas (20,21). However, the relationships between different sources of intratumoral heterogeneitygenetic, transcriptional and functional -remain obscure.Single cell transcriptome analysis by 23) should in principle enable functional characterization from landmark genes and annotated gene sets, relate in vivo states to in vitro models, inform transcriptional classifications based on bulk tumors, and even capture genetic information for expressed transcripts. To interrogate intratumoral heterogeneity systematically, we isolated individual cells from five freshly resected and dissociated human glioblastomas and generated single cell full-length transcriptomes using SMART-seq (96-192 cells/tumor, total 672 cells; Fig. 1A). Prior to sorting, the suspension was depleted for CD45 + cells to remove inflammatory infiltrate. As a control, we also generated population (bulk) RNA-seq profiles from the CD45-depleted tumor samples. All tumors were IDH1/2 wild type primary glioblastomas ( Fig. S1) and three were EGFR amplified as determined by routine clinical tests (Table S1). We exclude...

Although human tumours are shaped by the genetic evolution of cancer cells, evidence also suggests that they display hierarchies related to developmental pathways and epigenetic programs in which cancer stem cells (CSCs) can drive tumour growth and give rise to differentiated progeny1. Yet, unbiased evidence for CSCs in solid human malignancies remains elusive. Here we profile 4,347 single cells from six IDH1 or IDH2 mutant human oligodendrogliomas by RNA sequencing (RNA-seq) and reconstruct their developmental programs from genome-wide expression signatures. We infer that most cancer cells are differentiated along two specialized glial programs, whereas a rare subpopulation of cells is undifferentiated and associated with a neural stem cell expression program. Cells with expression signatures for proliferation are highly enriched in this rare subpopulation, consistent with a model in which CSCs are primarily responsible for fuelling the growth of oligodendroglioma in humans. Analysis of copy number variation (CNV) shows that distinct CNV sub-clones within tumours display similar cellular hierarchies, suggesting that the architecture of oligodendroglioma is primarily dictated by developmental programs. Subclonal point mutation analysis supports a similar model, although a full phylogenetic tree would be required to definitively determine the effect of genetic evolution on the inferred hierarchies. Our single-cell analyses provide insight into the cellular architecture of oligodendrogliomas at single-cell resolution and support the cancer stem cell model, with substantial implications for disease management.

Summary Developmental fate decisions are dictated by master transcription factors (TFs) that interact with cis-regulatory elements to direct transcriptional programs. Certain malignant tumors may also depend on cellular hierarchies reminiscent of normal development but superimposed on underlying genetic aberrations. In glioblastoma (GBM), a subset of stem-like tumor-propagating cells (TPCs) appears to drive tumor progression and underlie therapeutic resistance, yet remain poorly understood. Here, we identify a core set of neurodevelopmental TFs (POU3F2, SOX2, SALL2, OLIG2) essential for GBM propagation. These TFs coordinately bind and activate TPC-specific regulatory elements, and are sufficient to fully reprogram differentiated GBM cells to ‘induced’ TPCs, recapitulating the epigenetic landscape and phenotype of native TPCs. We reconstruct a network model that highlights critical interactions and identifies novel therapeutic targets for eliminating TPCs. Our study establishes the epigenetic basis of a developmental hierarchy in GBM, provides detailed insight into underlying gene regulatory programs, and suggests attendant therapeutic strategies.