Minnesota resident Rick Norenberg was facing a dire prognosis after being diagnosed with a rare form of pancreatic cancer. He explains how vigilance and a second opinion led to a new lease on life through a first-of-its-kind telemedicine clinical trial at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute (OSUCCC – James): I was one of those people who was never sick. I led a healthy lifestyle and typically ran multiple times per week. Then, in the summer of 2025, I had pain in my abdomen and progressing fatigue that doctors initially couldn't figure out. After some imaging, I received a shocking diagnosis of Stage 4 pancreatic cancer that had spread to my liver. As is so often the case with pancreatic cancer, the disease had progressed rapidly before being detected and was very advanced when it was discovered. I was given just months to live and was hospitalized several times. Traditional chemotherapy was attempted, but due to my poor health, I was unable to handle the chemo. Within a few weeks I was suffering from a severe brain fog, losing weight quickly and struggling with basic daily tasks including self-care. My first oncologist was resigned to following the usual route for my cancer, which honestly, would have led to the usual result. I challenged that and was able to get a second opinion from another staff oncologist who researched the genetic makeup of my tumors and identified that they were rare, evolving from something called an FGFR mutation. He discovered that there was a drug trial being conducted 800 miles from me at the OSUCCC – James in Columbus, Ohio. That team was working with a drug called Pemigatinib that was specifically designed to combat my mutation type. In my condition, I would not have been able to travel to Ohio regularly to participate in the trial. However, this drug trial was different — it was being conducted from Ohio State, but patients from anywhere in the country could participate My local oncologist in Minneapolis was able to work in step with Dr. Sameek Roychowdhury and his team of scientists at the OSUCCC – James. My local team handled daily medical care and performed the needed tests, imaging and labs for the Ohio State team, who watched and monitored my health and side effects. The care of the two teams working together was amazing. It turns out that my tumors responded very positively to the Pemigatinib regimen with few side effects. Within weeks, I was on my feet again and slowly returning to myself — no more brain fog, and my strength and stamina greatly improved. I progressed to taking daily walks of one to three miles and I’m now even able to do a little light running. I'm again managing my household independently. While Pemigatinib is not a cure, I am able to spend quality time with my young sons and the rest of my family. There is nothing that is more important than that. Because my tumor type is rare (up to 40% of cancers are of a rare type), without this trial being held remotely (decentralized), there would have been no way for me to take advantage of this treatment. Around 1000 pancreatic cancer patients per year have this FGFR mutation, but very few of them likely know about this medication and its possibilities. Imagine all the folks who could benefit from this treatment and be given more quality time with their families. I call on researchers, doctors, pharma companies and other stakeholders and decision makers in this field to help facilitate and normalize decentralized drug trials. You will literally be giving the gift of time to cancer patients that will be forever cherished. OSUCCC – James medical oncologist Sameek Roychowdhury, MD, PhD, was the principal investigator of the trial, and is a leading advocate for increased emphasis on telemedicine for cancer care. He shares his thoughts on Rick’s incredible story, and the importance of a team approach to decentralized cancer clinical trials around the world: We are so grateful that this clinical trial could impact Rick — a patient over 700 miles away. This is why we do biomedical research. We worked together with his local oncologist for routine care including blood work and CT scans while we managed his treatment, side effect assessments and response to Pemigatinib. All clinical trial responsibilities were completed by our team centrally at the OSUCCC – James. Patients and families facing metastatic cancer need access to novel treatment options beyond the current standard of care. Clinical trials are the vehicle for the development of novel treatments for cancer, yet participation remains low overall. There is a geographical barrier between where most clinical trials occur and where the patients live. Most clinical trials, due to their cost, complexity and expertise needed, occur in academic medical centers. Yet, the majority of oncologic care (90%) occurs in community practices. Distant clinical trials carry the burden of physically draining and repeated travel, housing, financial cost and time off from work or life for patients and family. If clinical trials could be completed faster and more efficiently, this could hasten progress for cancer research. We are now looking ahead. We’ve put forth a call to action for scientists to conduct decentralized therapeutic clinical trials in cancer, and to join together to share information. This group would spearhead education and learning from real-world efforts, support new therapeutic trial development by peers, facilitate access and accrual and foster engagement with industry partners for decentralized trials. Let’s bring the clinical trial to the patient. Cancer clinical trials: Oncologists are partnering with patients to save lives today while developing tomorrow’s groundbreaking treatments.