Rifaximin in Treating Patients with Monoclonal Gammopathy
                                  
                                      
                                          
                                          
                                              
                                              
                                                  Multiple Myeloma
Plasma cell neoplasm
                                              
                                           
                                          
                                          
                                              
                                              
                                                  18 Years and older, Male and Female
                                              
                                           
                                          
                                       
                                      
                                          
                                          
                                              
                                              
                                                  Winship4480-18 (primary)
NCI-2018-02106
IRB00106380
                                              
                                           
                                          
                                          
                                       
                                   
                               
                           
                          
                              
Summary
                              This phase I trial studies how well rifaximin works in treating patients with monoclonal gammopathy. Antibiotics, such as rifaximin, may help to kill bacteria in the intestines and reduce the abnormal protein or cells in patients with monoclonal gammopathy.
                          
                          
                              
Objectives
                              PRIMARY OBJECTIVE:
I. To evaluate the effect of a 2-week course of rifaximin on clonal immunoglobulin (Ig) in patients with monoclonal gammopathy.
SECONDARY OBJECTIVES:
I. To evaluate safety and tolerability of 2-week course of rifaximin.
II. To evaluate changes in stool microbiota by 16S sequencing.
III. To evaluate changes in gammopathy as assessed by changes in clonal Ig and/or plasma cells.
OUTLINE:
Patients receive rifaximin orally (PO) thrice daily (TID) on days 1-14 in the absence of disease progression or unacceptable toxicity. 
After completion of study treatment, patients are followed for up to 12 weeks from initiation of therapy.
                          
                          
                              Eligibility
                              
- Clinical diagnosis of asymptomatic gammopathy (monoclonal gammopathy of undetermined significance or asymptomatic myeloma or asymptomatic macroglobulinemia) based on International Myeloma Working Group (IMWG) criteria
 
- Patients will be enrolled into one of 3 cohorts:
* Cohort A: IgA gammopathy
* Cohort B: IgG gammopathy / or light chain gammopathy
* Cohort C: IgM gammopathy / asymptomatic macroglobulinemia
 
- Age >= 18 years
 
- Ability to understand and the willingness to sign a written informed consent document
 
                           
                          
                              Treatment Sites in Georgia
                             
                           
                           
                              
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