Rifaximin for the Treatment of Gastrointestinal Toxicities Related to Pertuzumab-Based Therapy in Patients With Stage I-III HER2 Positive Breast Cancer


About this study

This phase II trial studies how well rifaximin works for the treatment of gastrointestinal toxicities related to pertuzumab-based therapy in patients with stage I-III HER2 positive breast cancer. Rifaximin may reduce the incidence and severity of pertuzumab induced gastrointestinal toxicities without interrupting or delaying the chemotherapy schedule.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria: -PRE-REGISTRATION:

  • Histological confirmation of HER2 positive breast cancer stage I-III per American Joint Committee on Cancer (AJCC) staging 8th edition.
  • Provide written informed consent.
  • Breast cancer patients who will be receiving pertuzumab-based chemotherapy with either TCHP (docetaxel, carboplatin, trastuzumab, and pertuzumab) or docetaxel/paclitaxel, trastuzumab, and pertuzumab.
  • Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1, or 2. 
  • Hemoglobin ≥ 10.0 g/dL (obtained ≤ 30 days prior to pre-registration).
  • Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L (obtained ≤ 30 days prior to pre-registration).
  • Platelet count ≥ 100 x 10^9/L (obtained ≤ 30 days prior to pre-registration).
  • Additional Pre-Registration Inclusion Criteria may apply.

Inclusion Criteria - REGISTRATION:

  • Receiving pertuzumab based regimens in the adjuvant or neoadjuvant setting with pertuzumab dose of 840 mg.
  • Hemoglobin ≥ 10.0 g/dL (obtained ≤ 7 days prior to registration). 
  • Absolute neutrophil count (ANC) ≥ 1.5 x 10^9/L (obtained ≤ 7 days prior to registration).
  • Platelet count ≥ 100 x 10^9/L (obtained ≤ 7 days prior to registration).
  • Total bilirubin ≤ 1.5 x ULN (institutional upper limit of normal) (obtained ≤ 7 days prior to registration).
  • AST (SGOT)/ALT (SGPT) ≤ 2.5 x ULN (obtained ≤ 7 days prior to registration).
  • Serum or plasma creatinine ≤ 1.5 x ULN (obtained ≤ 7 days prior to registration).
  • Calculated creatinine clearance ≥ 45 ml/min using the Cockcroft-Gault formula (obtained ≤ 7 days prior to registration).
  • Additional Registration Inclusion Criteria may apply.


  • History of myocardial infarction =< 6 months prior to pre-registration, or congestive heart failure requiring use of ongoing maintenance therapy for life-threatening ventricular arrhythmias.
  • Failure to recover from acute, reversible effects of prior therapy regardless of interval since last treatment.
    • EXCEPTION: Grade 1 peripheral (sensory) neuropathy that has been stable for at least 3 months since completion of prior treatment
  • Uncontrolled intercurrent non-cardiac illness including, but not limited to:
    • Ongoing or active infection;
    • Psychiatric illness/social situations; 
    • Dyspnea at rest due to complications of advanced malignancy or other disease that requires continuous oxygen therapy;
    • Any other conditions that would limit compliance with study requirements.
  • Immunocompromised patients and patients known to be human immunodeficiency virus (HIV) positive and currently receiving antiretroviral therapy. 
    • NOTE: Patients known to be HIV positive, but without clinical evidence of an immunocompromised state, are eligible for this trial.
  • Receiving any other investigational agent which would be considered as a treatment for the primary neoplasm (adjust to protocol if applicable).
  • Additional Exclusion Criteria may apply.


Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Jacksonville, Fla.

Mayo Clinic principal investigator

Saranya Chumsri, M.D.

Open for enrollment

Contact information:

Cancer Center Clinical Trials Referral Office

(855) 776-0015

More information


Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

Not yet available


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