a, Comparison of neural signature between patient’s tumor tissue and cell culture in 17 glioblastomas. b,c, Survival after xenografting of patient-derived low- and high-neural glioblastoma cells in our internal cohort (b) and two combined external cohorts (c). log-rank test, P = 0.0009 (b), P = 0.001 (c). Error bands represent 95% CI. d, Primary patient-derived low- and high-neural glioblastoma cell suspensions (n = 1 per group) were implanted into premotor cortex (M2) of adult NSG mice (n = 5 mice per group). Mice were perfused after 8 weeks of tumor growth and brains sectioned in the coronal plane for further immunofluorescence analyses. e, Proliferation index (measured by total number of HNA+ cells co-labeled with Ki67 divided by the total number of HNA+ tumor cells counted across all areas quantified) in low- and high-neural glioblastoma-bearing mice (n = 5 mice per group). P = 0.00819, two-tailed Student’s t-test. Data are mean ± s.e.m. f, Representative confocal images of proliferation index in low-neural (top) and high-neural glioblastoma (bottom) xenografts. Human nuclear antigen (HNA), red; Ki67, green. Scale bars, 1 μm (overview images) and 200 μm (magnified images). g, Experimental workflow. h, EdU proliferation index (measured by total number of DAPI+ cells co-labeled with EdU divided by the total number of DAPI+ tumor cells counted across all areas quantified) in low-neural (P = 0.418) and high-neural (P = 0.0000172) glioblastoma as monocultures and co-cultured with neurons. Two-tailed Student’s t-test, n = 3 biological replicates. Data are mean ± s.e.m. i,j, 3D migration assay analysis comparing distance of migration 72 h after seeding (i) and representative images at time 0 h (left) and 72 h (right) of low- and high-neural glioblastoma cells (j). P = 0.0115, two-tailed Student’s t-test, n = 3 biological replicates. Scale bars, 1 μm. Data are mean ± s.e.m. k, In vivo spread of tumor cells into corpus callosum in low- and high-neural glioblastoma. P < 0.0004, two-tailed Student’s t-test. Data are mean ± s.e.m. EdU, 5-ethynyl-2′-deoxyuridine; DAPI, 4,6-diamidino-2-phenylindole.