20Temozolomide (TMZ) is a chemotherapy agent that adds mutagenic adducts to guanine, and is first-line 21 standard of care for the aggressive brain cancer glioblastoma (GBM). Methyl guanine methyl transferase 22(MGMT) is a DNA repair enzyme that can remove O6-methyl guanine adducts prior to the development 23 of catastrophic mutations, and is associated with TMZ resistance. However, inhibition of MGMT fails 24to reverse TMZ resistance. Guanines are essential nucleotides in many DNA and RNA secondary 25 structures. In several neurodegenerative diseases (NDs), disruption of these secondary structures is 26 pathogenic. We therefore took a structural view of TMZ resistance, seeking to establish the role of 27 guanine mutations in disrupting critical nucleotide secondary structures. To test whether these have 28 functional impacts on TMZ-resistant GBM, we focused on two specific guanine-rich regions: G-29 quadruplexes (G4s) and splice sites. Here we report broad sequence-and conformation-based changes 30in G4s in acquired or intrinsic TMZ resistant vs. sensitive GBM cells, accompanied by nucleolar stress 31and enrichment of nucleolar RNA:DNA hybrids (r-loops). We further show widespread splice-altering 32 mutations, exon skipping, and deregulation of splicing-regulatory serine/arginine rich (SR) protein 33 phosphorylation in TMZ-resistant GBM cells. The G4-stabilizing ligand TMPyP4 and a novel inhibitor 34 of cdc2-like kinases (CLKs) partially normalize G4 structure and SR protein phosphorylation, 35respectively, and are preferentially growth-inhibitory in TMZ-resistant cells. Lastly, we report that the 36 G4-and RNA-binding protein EWSR1 forms aberrant cytoplasmic aggregates in response to acute TMZ 37 treatment, and these aggregates are abundant in TMZ resistant cells. Preliminary evidence suggests these 38cytoplasmic EWSR1 aggregates are also present in GBM clinical samples. This work supports altered 39 nucleotide secondary structure and splicing deregulation as pathogenic features of TMZ-resistant GBM. 40It further positions cytoplasmic aggregation of EWSR1 as a potential indicator for TMZ resistance, 41establishes the possibility of successful intervention with splicing modulatory or G4-targeting agents, 42and provides a new context in which to study aggregating RNA binding proteins. 43 et al., 2014). TMZ causes DNA damage by adding mutagenic adducts to DNA, predominantly O6-methyl 52 guanine, a lesion that can be repaired by the suicide DNA repair protein methyl guanine methyl 53 transferase (MGMT)(Tentori and Graziani, 2009). The overall survival benefit provided by TMZ is ~ 4 54 months, and rapid development of TMZ resistance occurs at least in part through demethylation of the 55 MGMT promoter, allowing for the expression of MGMT(Zhang et al., 2012). However, efforts to re-56 sensitize tumors to TMZ by inhibiting MGMT activity have been unsuccessful(Marsoner et al., 2017). 57 TMZ preferentially targets guanines(Cheung-Ong et al., 2013), critical nucleotides in many DNA 58 and RNA secondary structures(Hänsel-...