The available evidence suggests that the lethality of glioblastoma is driven by small subpopulations of cells that self-renew and exhibit tumorigenicity. It remains unclear whether tumorigenicity exists as a static property of a few cells or as a dynamically acquired property. We used tumor-sphere and xenograft formation as assays for tumorigenicity and examined subclones isolated from established and primary glioblastoma lines. Our results indicate that glioblastoma tumorigenicity is largely deterministic, yet the property can be acquired spontaneously at low frequencies. Further, these dynamic transitions are governed by epigenetic reprogramming through the lysine-specific demethylase 1 (LSD1). LSD depletion increases trimethylation of histone 3 lysine 4 at the avian myelocytomatosis viral oncogene homolog (MYC) locus, which elevates MYC expression. MYC, in turn, regulates oligodendrocyte lineage transcription factor 2 (OLIG2), SRY (sex determining region Y)-box 2 (SOX2), and POU class 3 homeobox 2 (POU3F2), a core set of transcription factors required for reprogramming glioblastoma cells into stem-like states. Our model suggests epigenetic regulation of key transcription factors governs transitions between tumorigenic states and provides a framework for glioblastoma therapeutic development.epigenomics | glioblastoma | neoplastic stem cells G lioblastoma is the most common primary brain cancer and remains one of the deadliest of malignancies despite contemporary treatment strategies (1), with near-uniform fatality within 2 y of diagnosis (2, 3). There is growing evidence that the lethality of this tumor is driven by subpopulations of cells with properties of self-renewal and tumorigenicity (4)-that is, the capacity to generate phenocopies of the original tumor when transplanted (5, 6). How glioblastoma cells retain or gain tumorigenicity while the bulk of the tumor does not remains a fundamental question. Conceptualization of this phenomenon includes the elite and stochastic models (7). The elite model states that restricted cell subpopulations harbor intrinsic tumorigenic properties that cannot be acquired once lost. The stochastic model, on the other hand, presupposes that all cells within a population are intrinsically comparable in their ability to spontaneously acquire or lose tumorigenicity.Epigenetic alterations are stable, long-term changes in cellular phenotype that are not due to variations in DNA sequence (8). One means by which epigenetic alterations impact cell phenotype involves modulation of transcriptional activity via histone modification (9). Here we demonstrate that glioblastoma tumorigenicity is best conceptualized by a hybrid elite-stochastic model governed by histone modification through the lysine-specific demethylase 1 (LSD1; aka KDM1A) (10). This modification, in turn, influences the expression of key transcription factors required to reprogram glioblastoma cells into a stem-like state, including avian myelocytomatosis viral oncogene homolog (MYC) (11), oligodendrocyte lineage transcri...