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Rebuilding Health

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. 

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

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