• Cancer patients with either solid tumor, or hematological malignancies, independent of stage of the disease. However, patients with large tumor burden in highly vasculated tissue (eg lung) are at risk for tumor lysis syndrome
• Patients infected by different viruses (HSV, VZV, EBV, HPV, HBV, HCV, HIV, Coxsackie, etc.)
• Patients with Lyme Disease (infected by Borrelia, Bartonella, Babesia strains)
• Patients infected by Anaplasma, Rickettsia, Ehrlichia strains

*Please see our complete list for further info on the appendix

• Cancer patients with CNS cancer
• Cancer patients < 11 years old
• Patients < 5 years old infected by different viruses or other strains
• Patients under Gamma Delta T Cell Therapy (GDTC)
• Patients under treatment with Radioactive Seeds

• Pregnancy or breastfeeding – must wait 6 months
• Recent blood transfusion – must wait 120 days
• Recent cytotoxic chemotherapy and/or radiotherapy – must wait 14-21 days
• Radioactive Seed Therapy (permanent contraindication for Cancer only)
• Delta T. Cell Therapy (GDTC) (permanent contraindication for Cancer only)
• Children under the age of 11 for cancer
• Children under the age of 5 for viral or Lyme

• The patient must be off cytotoxic therapies and free radical producing substances 7-21 days prior to the blood draw for the Q- REstrain and again 7-21 days prior to the actual administration of the Q-REstrain therapy. Some therapies require a longer time frame.  See below for details.
  • Blood Transfusions: at least 120 days
  • CDK Inhibitors: for at least 14 days
  • Chelation Therapy (IV): Avoid at least 14 days
  • Chemotherapy (non-platinum derivative): at least 14 days
  • Chemotherapy (platinum derivative): at least 21 days
  • Cryoablation: at least 7 days
  • Fever: at least 14 days
  • Gamma Delta T Cell Therapy (GDTC): Patients are not eligible for therapies due to the potential interaction with RGCC therapies.
  • Hormone suppression: at least 14 days (½ life x 7 is ideal formula for avoidance)
  • Hyperbaric Therapy: at least 7 days
  • Hyperthermia (generalized/systemic): no waiting
  • Hyperthermia (local/concentrated/microwave ablation): at least 30 days due to increased cellular debris released into the bloodstream
  • Immune Suppression Medication: at least 14 days
  • Methylene Blue: at least 14 days
  • Mistletoe: Avoid for at least 21 days
  • MOAB or SMW drugs: for at least 14 days
  • Natural Substances (IV): cytotoxic substances like Vitamin C or Ozone at least 14 days.
  • Natural Substances (oral supplements): Class 1 or 3 cytotoxic substances (per patient’s Onconomics Plus results) at least 14 days.
  • NK1 Inhibitors: for at least 14 days
  • NSAIDS: Do not have to be discontinued
  • Off Label Medications: Ivermectin-FenBen-Itraconazole: 14 days
  • Off Label medication: Doxycycline: 7 days
  • Off Label Medication: Metformin: 21 days
  • PEMF Therapy: at least 7 days
  • Plasmapheresis: Potential risk but not studied. Use your own discretion.
  • Radiation: at least 14 days
  • Radioactive Seeds: Patients are not eligible for therapies due to the prolonged and undetermined time of the radiation exposure
  • Scans with Contrast: at least 14 days
  • Surgery (brain or extensive): minimum of 30 days based on time of recovery. Could be longer if slow recovery or if the person had some type of adverse reaction. Must be evaluated on a case-by-case basis.
  • Surgery (simple/routine): at least 7-10 days

• The patient must be off all therapies for 14 days prior to the blood
  draw for the Q-REstrain and again 14 days prior to the actual
  administration of the Q-REstrain therapy. This includes:
  • Antibiotics (oral or IV)
  • Antiviral medications (oral or IV)
  • Anti-parasitic medications (oral or IV)
  • Methylene Blue
  • Rife (if targeting pathogens)
  • Scan with contrast
  • Vitamin C (IV)
  • Colloidal Silver (oral or IV)
  • H2O2 IV
  • Ozone (IV)
  • Natural Substances (ALL oral supplements that are trying to kill or suppress the same target as the Q-REstrain)

• Positive test results confirming presence of CTCs (Oncotrace, Oncotrail or Oncocount)
• Test result must be within six (6) months (date of blood draw)
• Pathology results will not be accepted

• Positive test result confirming presence of the targeted pathogen
• Test result can be PCR or antibody result
• Test result must be serum-based results (urine are not accepted)
• Pathology results will not be accepted
• IND or NPS will be accepted but these results run a higher risk of the pathogen not being found and a cancellation fee being incurred.
• Test result must be within six (6) months (date of blood draw)
• Test must be from a reputable lab
• The purpose of the blood draw guidelines is to ensure the highest level of accuracy of the targeting by removing treatments and/or substances that may interfere with this. The average patient is on a multitude of substances so often it’s best to just cease all potentially interfering substances prior to the blood draw. However, if a patient is unwilling or unable to cease all substances, then the physician or the patient themselves will have to decide what is the most likely substance to interfere with the test results

• 15-30ml whole blood in RGCC vials (1 glass vial) is enough for 1 to 2 Q-REstrain

• One Q-REstrain vial

• The production to delivery period is approximately 15 days.
• The delivery shipment schedule varies from one to two weeks.

• Cancer - Maximum of four (4) total in a 12-month period (must be spaced at a minimum of three months apart)
• Viral or Lyme - Maximum of nine (9) total in a 12-month period (must be spaced a minimum of (7) days apart)
• Q-REstrain for the same target must be spaced at a minimum of (3) three months apart and you must provide updated test results that shows the pathogen is still present before a repeat for the same pathogen will be allowed.

• If multiple therapies (more than 2) are ordered for the same patient, they will not all be shipped at the same time anymore. The new policy is that a maximum of 2 therapies will be shipped at any one time for the same patient.
• There will be a two-week period between each set of 2. Once again, only for the same patient.
• The lab will use their best judgment to establish shipping order. Thus, if you (the practitioner) have a preferred shipment order, you will need to inform the lab which therapies they would like shipped first, second, third, etc. until all therapies have been dispatched. This is done in response to the Incoming Samples email.
• Q-REstrain can be delivered only to RGCC registered clinic or physicians. Never send a Q-Restrain directly to a patient.

• Q-REstrain in the dried form can be stored for up to six months if kept at room temperature and protected from light. Storage in a drawer or in a climate-controlled environment is acceptable.
• Q-REstrain after reconstitution can be stored in a freezer at -17 to - 23C for up to 21 days. Longer than 21 days needs to be stored at - 80C

• NS 250 ml bag
• IV Tubing
• Injection Plug with Cap
• 22 G IV Catheter
• Extension Tubing Set
• (3) 3 ml syringes (one for 1 ml sterile water, two for drawing up pre- meds)
• 10 ml syringe Label with: Patient name, Q-REstrain therapy #)
• 20 ml syringes -pre-meds will be added - Label dexamethasone and famotidine)
• 60 ml syringe (to draw off NS waste from 250 ml bag)
• 10 ml NS IV Flush syringes (1 for after each pre-med and 2 for after Q-REstrain)
• 20 G 1 ½” needles (for 2 pre-med syringes, Q-REstrain syringe)
• 20 G 1” needles (for NS flushes)
• 16 G needle (for 60 ml syringe)
• Vented Vial Access Spike (for IV bag)
• Famotidine vial (unless patient is taking it PO)
• Dexamethasone vial

• Upon receipt of the Q-REstrain, you will need to cross-reference the number on the Q-REstrain container to your patient’s name. There will not be a name on the actual Q-REstrain container so this is important.
• Inspect immediately upon receiving. Q-REstrain is sterile, freeze dried-lyophilized synthetic oligonucleotides and can be stored at ambient room temperature and out of direct light for up to six (6) months if never opened.
• The vial top should be wrapped with a sealed tamper proof tape.
• The crystal/powder/gel-drop like, is very tiny and should be clear or white only. Your clinic may want to obtain a strong magnifying glass for this purpose. If the crystals are other than clear or white, do not administer the Q-REstrain, the vial has been compromised. Contact RGCC for a replacement.
• The Q-REstrain is freeze dried, but do not expect a powder form. The Q-REstrain is actually closer to a tiny crystal (it can be confused with a drop sometimes) so if you see a small, clear and gel-like drop at the bottom of the vial that is normal. With a gentle swirling, the crystal should remain in the initial position, while a true humidity drop will move. Additionally, if you are not able to easily see through the vial then that is true humidity. Do not administer the Q-REstrain. Contact RGCC for a replacement.
• If there are foreign bodies observed after reconstitution (wait at least 10 minutes after reconstitution, true foreign bodies will not dissolve), DO NOT administer the Q-REstrain. Contact RGCC for a replacement.
• If any of the above occurs, please take a picture and email to the
  appropriate branch/distributor.

• Dissolve the tiny amount of powder/crystals by adding 1 ml of sterile water to the Q-REstrain vial. Do not use saline to dissolve the crystals
• Close the screw cap, vortex (swirl) the vial gently until the solution becomes clear with no remaining precipitant – Do not shake or use sonication to mix
• Draw 9 ml of normal saline in a 10ml syringe
• Draw up the 1 ml of reconstituted Q-REstrain into the 9 ml of normal saline into the syringe
• Tilt back and forth gently to mix
• The Q-REstrain is now reconstituted and ready to be infused

• Proceed to the steps of “preparation” and then follow the next steps
• Use a marker and mark the 5 ml spot on the syringe
• Administer the first half (5 ml) of the reconstituted Q-REstrain
• Transfer the remaining 5 ml of reconstituted Q-REstrain solution into a cryo vial (this is not provided by the lab).
• Do not freeze in the syringe to avoid repeated freeze/thaw cycles since it could destroy the Q-REstrain molecules
• Place the remaining 5 ml into the freezer immediately between -17°C and -23 °C (the colder the better). The Q-REstrain can be stored at this temperature for a maximum of 21 days.
• If planning to infuse the second half longer than 21 days, it must be stored at -80°C (it is then stable for up to 6 months). Note: if splitting the doses into more than just half, split the doses and freeze them individually in cryo vials. Once again, do not freeze in the syringe

• To minimize any possible allergic reaction, RGCC recommends
  administering:
  • Mandatory: Dexamethasone 4 mg diluted in 0.9% Sodium Chloride 20 -50 ml bag right before administering the Q-REstrain or can be administered as a slow push (bolus)
  • Optional: A H2 Blocker (Famotidine, Cimetidine, Nizatidine) as well as Acetaminophen are recommended but are not mandatory. However, they are routinely administered to decrease any chance of headache, nausea, vomiting or diarrhea from occurring.
    • Famotidine 20 mg (or other as outlined above) diluted in 20 ml syringe. (Note: If giving orally, must be given six hours before the Q-REstrain is administered)
    • Acetaminophen 500mg of (Tylenol) P.O. and continue every 8 hours for three days if needed

• Place an IV catheter using standard techniques and verify a good flow
• Start with a minimum of a 50 – 100 ml bag of saline (using a 250 ml bag has been reported to result in the patient feeling better overall post infusion)
• Infuse Famotidine as a slow push (wait 30-45 minutes before next step)
• Infuse Dexamethasone as slow bolus push or rapid drip
• Administer the Q-REstrain preparation (1/2 {5 ml} dose or {10ml} full dose) as a slow push at approx. 1 ml per 5 seconds (let the saline solution run a few seconds in between the 1ml slow push) through the IV route
• After Q-REstrain has been infused, flush the IV access with 20 ml of normal saline solution
• Monitor the patient for possible adverse reaction for the next 45-60 minutes
• Remove IV catheter following standard procedures

• Headaches
• Increased fatigue
• Flu like symptoms
• In Cancer - pain at surgical site can occur
• In Cancer - TLS syndrome mainly with highly vasculated tumors (eg lung)
• In Lyme or viral - co-infections can flare

• For Cancer (Apoptosis):
  • All therapies may be resumed (as outlined above) 14 days after administration
  • IV-C can be resumed after 7 days
• For Virus/Lyme (V. Antagonist):
  • All therapies may be resumed (as outlined above) 7 days after administration
• Wait at least 7 days after the Q-REstrain infusion to resume PEMF, Rife or HBOT

• Biofilm busters
• Oral detox supplements such as glutathione
• Cytokine reducers
• Binders
• Routine supplements like multivitamins, vitamin D, probiotics, etc.
• Foot baths

• Tumor Lysis Syndrome – TLS (fever, local edema, accumulation of fluid in the area of the tumor, etc) is a potential risk with Q-REstrain and patients should be properly evaluated prior to ordering the therapy. TLS occurs mainly with highly vasculated tumors (eg lung) or numerous tumors. It is important that physicians are educated on how to treat TLS if administering it to cancer patients at risk for this.
• Even if the tumor load is under 5 cm and TLS is not a concern, the lysis of tumors can cause discomfort depending on the location of the tumors (bone, lymph nodes, rectal, etc.). Patients should be warned of this and a pain management plan should be in place

• For Cancer: Oncotrace or Oncotrail RGCC are recommended every 3-4 months after the administration of the Q-REstrain to evaluate the status of the CTC and the immunophenotypes.
• For Viral or Lyme: The same lab that was used to order the Q- REstrain should be used to evaluate the status of the pathogen 4-6 months after the Q-REstrain administration.

• The RNAi technology has shown:
  • Cancer Patients: Approximately 78% of cases had a positive clinical outcome (Complete response or Partial response or Stable disease)
  • Virus Infected Patients: The positive clinical outcome reached 91%
  • Lyme Disease: Approximately 95% of cases had a positive clinical outcome (percentages include Borrelia, Bartonella and Babesia)

• For virus or Lyme – There is a minimum of seven (7) days between two different Q-REstrain. Upon our network experience a space at 21-30 days apart to give time to evaluate their patient before infusion the next one it is recommended.
• For cancer – Three (3) to four (4) months apart with a maximum of four (4) in a 12-month period

• For Lyme/Viral: Q-REstrain for Lyme for children over the age of 5 (Reason: the sequence of interest has no overlapping parts with human genome)
• For Cancer: Q-REstrain For malignancies for children over the age of 11 is at the discretion of the Physician. An evaluation of the thymus gland to verify it is atrophic is recommended for a child under the age of 10. (Reason: An overlapping of 60% of the Q- REstrain sequence may generate heterodimers between mRNA and Q-REstrain which has no consequence in adults, but in children when the clones of auto-epitopes have not been locked then there is a small (but not zero) possibility to create an autoimmune clone of B cells that may generate an autoimmune condition in the future. It’s important that the physician and the parents be made aware of this potential risk.
• RGCC has not performed studies on children. The recommendations are based on published literature about the immune system and the thymus gland.