Rebuilding Health

VICTOR RIGDON CAN fix just about anything. A carpenter at the Indiana State Fairgrounds, he repairs buildings, restores benches and flower boxes—anything. But three years ago, Rigdon found something he couldn’t fix.  His cough. Rigdon didn’t hack. He didn’t ache. It was just a light cough. When he left a walk-in medical clinic with a prescription for antibiotics, Rigdon figured the cough would soon be gone.  Ten days later, Rigdon sat in an exam room and stared as his physician […]

Vic State Fair Elks

VICTOR RIGDON CAN fix just about anything. A carpenter at the Indiana State Fairgrounds, he repairs buildings, restores benches and flower boxes—anything. But three years ago, Rigdon found something he couldn’t fix. 

His cough.

Rigdon didn’t hack. He didn’t ache. It was just a light cough. When he left a walk-in medical clinic with a prescription for antibiotics, Rigdon figured the cough would soon be gone. 

Ten days later, Rigdon sat in an exam room and stared as his physician showed him a scan of his lungs—the left brimming with fluid. It led to a referral to a pulmonologist, a biopsy—all ominous signs. 

Finally, in August 2016, the root of the cough was discovered by Greg Durm, MD, an oncologist at Indiana University Melvin and Bren Simon Cancer Center and assistant professor of clinical medicine at IU School of Medicine.

Rigdon had non-small cell lung cancer—stage 4. It had gained a foothold in Rigdon’s lung and spine. The most optimistic outlook gave him a year to live. “There had been no warning,” Rigdon said. “Now, it was like, it’s spread. It’s terminal.”

What followed, though, was a workmanlike process that led Durm to pull from his bag one of the newest tools in cancer treatment—one being developed right here at IU.

Greg Durm, MD, an assistant professor of clinical medicine, is leading a clinical trial at IU Simon Cancer Center that explores whether immunotherapy works best alone or in tandem with traditional chemotherapy drugs.

WHEN LUNG CANCER takes root in a patient’s bone, it’s deemed incurable. The objective of treatment shifts from a cure to wrestling the disease into submission. For Rigdon, 49, it means facing a siege that will span decades. 

Rigdon knew two decades of smoking could exact a toll, but he figured it was still years away. “I just didn’t think at that age it was going to happen,” he said. 

In the aftermath of the diagnosis, Rigdon embarked on a well-worn path for lung cancer patients—four rounds of chemotherapy. Scans revealed a stalemate: His cancer wasn’t spreading, but the tumors weren’t shrinking. 

To Durm, treating patients has some similarities to Rigdon’s craft. Each case requires his expertise and an assortment of tools to solve a vexing problem. Every patient comes with their own disease, set of genetic factors and emotions. 

“If it was just a recipe for each patient, you wouldn’t really need doctors,” Durm said. “You would just plug their information into a computer.”

Durm is a physician who also works doggedly to find innovative treatments. Alongside fellow researchers at IU Simon Cancer Center, he’s exploring how immunotherapy drugs—which boost the body’s own defenses to fight cancer—can be used alone, or in tandem, with traditional chemotherapy. 

One of the pressing questions facing oncologists today is what to do once an immunotherapy drug stops working. Move on to another chemotherapy drug? Combine immunotherapy with chemo? 

Put another way, how could Durm help patients in the same predicament as Rigdon? 

Durm considered switching up chemotherapy drugs but knew the odds of success were slim. Instead, he pitched another option: a recently approved immunotherapy drug called Tencentriq. The drug blocks a protein on the surface of cancer cells—a checkpoint inhibitor–unmasking them and enabling immune cells to snuff them out. 

Rigdon was also an ideal candidate—relatively young and unscathed by chemotherapy. After his diagnosis, he remained well enough to take extended trips to the Gulf Coast, Seattle, and to Maryland. He also returned to work at the Indiana State Fairgrounds.

When Durm floated the idea of the new drug, Rigdon quickly concluded: “I can’t not do it.” 

His immune system was in a good state that it could sort of be enhanced by this drug. He didn’t get any side effects, which is actually not uncommon. We have tons of patients on immunotherapies who don’t get any side effects from these medicines.

Greg Durm, MD, on Victor Rigdon’s response to immunotherapy

THE RESULTS WERE nearly instant. After a few treatments, the cancer significantly shrunk in size. 

“His immune system was in a good state that it could sort of be enhanced by this drug. He didn’t get any side effects, which is actually not uncommon,” Durm said. “We have tons of patients on immunotherapies who don’t get any side effects from these medicines.”

Drugs like Tencentriq are steadily becoming frontline therapies, and Durm is leading a clinical trial investigating how well they work when paired with chemotherapy drugs. The approach is unique, and the entire project—design, patient recruitment and data analysis—will take place at IU. 

As the state’s lone academic health center, IU draws a diverse group of patients to Indianapolis and IU Simon Cancer Center, which is a hub for such trials and research. Researchers like Durm also tap into the expertise of the Hoosier Cancer Research Network to find additional sites, get clarity of regulatory questions, and receive advice on protocols. 

Durm has benefited from charitable gifts from donors like the Indiana Elks. The support covers the nuts and bolts of conducting novel research–data entry, a research nurse to ensure patients qualify for a trial, and additional lab testing. Bland as those might sound, they’re pivotal in answering the kinds of questions that save patients’ lives. 

“Without it, a lot of junior faculty would fail,” Durm said. “They fund a lot of the correlative research we do, and that really helps us understand why something worked or didn’t.”

Rigdon’s disease remains in check. His treatment amounts to getting stuck with a needle every three weeks and taking a half-day off from work. “If ain’t broke, don’t fix, right?” Rigdon says. And he has other, more pressing concerns–like the itinerary for his next trip.

“It’s been part of my decision to just do things,” he said. “I’m just going to live as long as I can and as well as I can. This probably keeps me feeling well and has me kept me healthy.”

To learn more about or support lung cancer research at IU School of Medicine, contact Amber Kleopfer Senseny at akleopfe@iu.edu or 317-278-4510.

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