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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Stem Cells. Sep 26, 2026; 18(9): 124540
Published online Sep 26, 2026. doi: 10.4252/wjsc.124540
MED12 mutation activates Notch signaling to enhance cancer stemness and suppress CD8+ T cell cytotoxicity in lung cancer
Ying Yang, Jin-Long Zhong, Jia-Yuan Liu
Ying Yang, Jinshan Hospital Center for Tumor Diagnosis & Therapy, Jinshan Hospital of Fudan University, Shanghai 201508, China
Jin-Long Zhong, Jia-Yuan Liu, Department of Thoracic Surgery, Jinshan Hospital of Fudan University, Shanghai 201508, China
Author contributions: Yang Y and Zhong JL contributed to writing - original draft; Yang Y contributed to conceptualization, investigation, resources, and supervision; Zhong JL contributed to data curation, project administration, validation, and visualization; Liu JY contributed to formal analysis, methodology, software, funding acquisition, and writing - review and editing.
AI contribution statement: Portions of this manuscript were edited using AI tools solely for language refinement. The authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Supported by 2024 Jinshan District Health Special Research Project - General Program, No. JSKJ-KTMS-2024-02.
Institutional review board statement: There are no experiments involving human participants or animal subjects were required.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Jia-Yuan Liu, Chief Physician, Department of Thoracic Surgery, Jinshan Hospital of Fudan University, No. 1508 Longhang Road, Jinshan District, Shanghai 201508, China. ljyuan1985@163.com
Received: June 22, 2026
Revised: July 18, 2026
Accepted: September 18, 2026
Published online: September 26, 2026
Processing time: 96 Days and 17.7 Hours
Abstract
BACKGROUND

Mediator complex subunit 12 (MED12) somatic mutations occur frequently in various tumors and are involved in tumor progression.

AIM

To evaluate the role and mechanism in lung cancer.

METHODS

MED12-associated genes were subjected to enrichment analysis. MED12-mutant NCI-H322 cells and MED12-non-mutant PC9 cells were used to evaluate the mutation’s effects on stemness, employing sphere formation, chromatin immunoprecipitation quantitative polymerase chain reaction, and flow cytometry. The association between MED12 and the tumor immune microenvironment was analyzed by integrating bulk transcriptomic and single-cell transcriptomic data. Chemotaxis and cytotoxic functions of CD8+ T cells were assessed using a co-culture model of tumor cells and CD8+ T cells.

RESULTS

Stem cell maintenance and Notch pathway regulation were identified as the main enriched categories for MED12-associated genes by bioinformatics analysis. Compared with non-mutant cells, MED12 mutation was associated with enhanced the sphere-forming ability, increased the ALDH1-positive cells and elevated Notch pathway activity. Treatment with the Notch inhibitor γ-secretase inhibitor (DAPT) partially reversed the observed effect of MED12 mutation on maintaining cancer stemness. Integration of bulk and single-cell transcriptomics revealed that MED12 expression is inversely associated with CD8+ T cell infiltration, with its differentially expressed genes being enriched in CD8+ T cell pathways, pointing to a potential immunomodulatory role. MED12-mutant tumor cells exhibited significantly higher surface programmed death ligand-1 expression than non-mutant cells, which was reversed by DAPT. In co-culture experiments using these cell lines, CD8+ T cells co-cultured with MED12-mutant lung cancer cells showed inhibited chemotaxis and reduced release of interferon-γ, tumor necrosis factor-α, perforin, and granzyme-B, while exhibiting significantly increasing programmed cell death 1. Furthermore, the killing capacity of CD8+ T cells against MED12-mutant lung cancer cells was attenuated. However, DAPT treatment partially reversed the MED12 mutation-induced suppression of CD8+ T cell function.

CONCLUSION

This study reveals the key role of the MED12 mutation in lung cancer progression, providing a new theoretical basis for lung cancer immunotherapy.

Keywords: Lung cancer; MED12 mutation; Stemness; CD8+ T; Notch signaling

Core Tip: Mediator complex subunit 12 mutation in lung cancer cells activates Notch signaling, which concurrently promotes cancer stemness - characterized by enhanced sphere formation and increased ALDH1+ cells - and induces immune evasion via upregulation of surface programmed death ligand-1 on tumor cells. This leads to impaired CD8+ T cell chemotaxis, reduced release of effector molecules (interferon-γ, tumor necrosis factor-α, perforin, granzyme-B), and increased programmed cell death 1 expression. Notch inhibitor DAPT reverses these pro-tumor effects.

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