For many patients, the cancer continuum includes a syndrome known as cancer-associated cachexia (CAC), which encompasses the unintended loss of body weight and muscle mass, and is often associated with fat loss, decreased appetite, lower tolerance and poorer response to treatment, poor quality of life, and reduced survival. Unfortunately, there are no effective therapeutic interventions to completely reverse cancer cachexia and no FDA-approved pharmacologic agents; hence, new approaches are urgently needed. In May of 2022, researchers and clinicians from Moffitt Cancer Center held an inaugural retreat on CAC that aimed to review the state of the science, identify knowledge gaps and research priorities, and foster transdisciplinary collaborative research projects. This review summarizes research priorities that emerged from the retreat, examples of ongoing collaborations, and opportunities to move science forward. The highest priorities identified include the need to (1) evaluate patient-reported outcome (PRO) measures obtained in clinical practice and assess their use in improving CAC-related outcomes; (2) identify biomarkers (imaging, molecular, and/or behavioral) and novel analytic approaches to accurately predict the early onset of CAC and its progression; and (3) develop and test interventions (pharmacologic, nutritional, exercise-based, and through mathematical modeling) to prevent CAC progression and improve associated symptoms and outcomes.

The concept of individual cellular intelligence reframes cells as dynamic entities endowed with sensory, reactive, adaptive, and memory-like capabilities, enabling them to navigate lifelong metabolic and extrinsic stressors. A likely vital component of this intelligence system is stress-responsive G protein-coupled receptor (GPCR) networks, interconnected by common signaling adaptors. These stress-regulating networks orchestrate the detection, processing, and experience retention of environmental cues, events, and stressors. These networks, along with other sensory mechanisms such as receptor-mediated signaling and DNA damage detection, allow cells to acknowledge and interpret stressors such as oxidative stress or nutrient scarcity. Reactive responses, including autophagy and apoptosis, mitigate immediate damage, while adaptive strategies, such as metabolic rewiring, receptor expression alteration and epigenetic modifications, enhance long-term survival. Cellular experiences that are effectively translated into ‘memories’, both transient and heritable, likely rely on GPCR-induced epigenetic and mitochondrial adaptations, enabling anticipation of future insults. Dysregulation of these processes and networks can drive pathological states, shaping resilience or susceptibility to chronic diseases like cancer, neurodegeneration, and metabolic disorders. Employing molecular evidence, here, we underscore the presence of an effective cellular intelligence, supported by multi-level sensory GPCR networks. The quality of this intelligence acts as a critical determinant of somatic health and a promising frontier for therapeutic innovation. Future research leveraging single-cell omics and systems biology may unravel the molecular underpinnings of these capabilities, offering new strategies to prevent or reverse stress-induced pathologies.

The concept of individual cellular intelligence reframes cells as dynamic entities endowed with sensory, reactive, adaptive, and memory-like capabilities, enabling them to navigate lifelong metabolic and extrinsic stressors. A likely vital component of this intelligence system are stress-responsive G protein-coupled receptor (GPCR) networks, interconnected by common signaling adaptors. These stress-regulating networks orchestrate the detection, processing, and experience retention of environmental cues, events, and stressors. These networks, along with other sensory mechanisms such as receptor-mediated signaling and DNA damage detection, allow cells to acknowledge and interpret stressors such as oxidative stress or nutrient scarcity. Reactive responses, including autophagy and apoptosis, mitigate immediate damage, while adaptive strategies, such as metabolic rewiring, receptor expression alteration and epigenetic modifications, enhance long-term survival. Cellular experiences that are effectively translated into ‘memories’, both transient and heritable, likely relies on GPCR-induced epigenetic and mitochondrial adaptations, enabling anticipation of future insults. Dysregulation of these processes and networks can drive pathological states, shaping resilience or susceptibility to chronic diseases like cancer, neurodegeneration, and metabolic disorders. Employing molecular evidence, here we underscore the presence of an effective cellular intelligence, supported by multi-level sensory GPCR networks. The quality of this intelligence acts as a critical determinant of somatic health and a promising frontier for therapeutic innovation. Future research leveraging single-cell omics and systems biology may unravel the molecular underpinnings of these capabilities, offering new strategies to prevent or reverse stress-induced pathologies.