NWU2017-09-01 Protocol Version 6.5, May 11, 2020 COVER PAGE DCP Protocol #: NWU2017-09-01 Local Protocol #: NCI 2017-09-01 PHASE I TRIAL OF ENDOXIFEN GEL VERSUS PLACEBO GEL IN WOMEN UNDERGOING BREAST SURGERY Consortium Name: Northwestern Cancer Prevention Consortium Organization Name: Northwestern University Name of Consortium Principal Seema A. Khan, M.D. Investigator: 303 E. Superior, Suite 4-111 Chicago, IL 60611 Tel: (312) 503-4236 Fax: (312) 503-2555 E-mail:
[email protected] Organization Name: Northwestern University Protocol Principal Seema A. Khan, M.D. Investigator and Protocol Chair: Professor of Surgery 303 E. Superior, Suite 4-111 Chicago, IL 60611 Tel: (312) 503-4236 Fax: (312) 503-2555 E-mail:
[email protected] Organization: Memorial Sloan-Kettering Cancer Center Investigator: Melissa Pilewskie, M.D. Evelyn H. Lauder Breast Center 300 East 66th Street New York, NY 10065 Tel: 646-888-4590 Fax: 646-888-4921 E-mail:
[email protected] Organization: Cedars-Sinai Medical Center Investigator: Scott Karlan, M.D. Saul and Joyce Brandman Breast Center in the Samuel Oschin Cancer Center 310 N. San Vicente Blvd., Room 314 West Hollywood, CA 90048-1810 Tel: (310) 423-9331 Fax: (310) 423-9339 E-mail:
[email protected] Organization: Northwestern University Statistician: Masha Kocherginsky, Ph.D. 680 N. Lake Shore Dr., Suite 1400 –1– NWU2017-09-01 Protocol Version 6.5, May 11, 2020 Chicago, IL 60611 Telephone: (312) 503- 4224 Fax: (312) 908- 9588 Email:
[email protected] IND Sponsor: NCI/Division of Cancer Prevention IND# Agent(s)/Supplier: National Cancer Institute NCI Contract # HHSN2612201200035I Protocol Template: Version 8.5 08/31/2016 Protocol Version Date: May 11, 2020 Protocol Revision or Amendment # Version 6.5 –2– NWU2017-09-01 Protocol Version 6.5, May 11, 2020 SCHEMA NWU2017-09-01: Phase I trial of endoxifen gel versus placebo gel in women undergoing breast surgery Women scheduled for mastectomy1 Screening Visit 1 – consent, baseline tests, BESS Q, skin photos 2:1 Randomization in Cohorts 1 and 2.