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Ribavirin Frequently Asked Questions Revised July 30, 2009

What is ribavirin?Ribavirin is an old drug that has been used for years to treat serious virus infections like RespiratorySyncytial Virus (RSV) or hepatitis C virus (HCV). There is new human research from McGill Universityand University of Montral which shows that ribavirin can safely and successfully treat a type of bloodcancer called AML with minimal side effects ( Molecular targeting of the oncogene eIF4E in AML: a proof-of-principle clinical trial with ribavirin, Blood, May 2009 ).

What were the trial results?The first human trial of ribavirin as a cancer treatment was performed in type M4/M5 AML patients. In thistrial of 13 patients, 11 could be evaluated for response. A total of 9 out of 11 patients responded toribavirin (82%), with 4 out of 11 having stable disease (36%), 4 out of 11 showing improvement (36%)and 1 patient with complete remission (9%).

How does it work?Ribavirin works by interfering with a protein called eIF4E that plays a key role in tumour cell growth,survival, metastasis and angiogenesis (growth of new blood vessels). Ribavirin causes the cancer cells todie and blocks them from growing new blood supply to feed themselves.

Does ribavirin work on any other cancers besides leukemia?It is exciting to note that extensive research has been done which shows that eIF4E is vital to many other cancers for survival, growth, metastasis and angiogenesis. These include:

Bladder (transitional cell carcinoma)BreastCervixColon

GlioblastomaHead and Neck (squamous cell carcinoma)LungLymphomaProstate

Based on this, we believe that ribavirin will have a role in the treatment of these cancer types, andpossibly others as well. This has not yet been established by formal human research. However, we nowhave preliminary data that shows ribavirin can work in colon cancer synergistically with DCA. This datacomes from a ChemoFit test of a single patient. The results showed 5% response to DCA (5% of cancer cells killed), 16% response to ribavirin and 59% response to both drugs combined.

Is it safe?

In the human research noted above, there were no serious side effects reported from ribavirin treatment.The most serious ribavirin side effect reported in the literature is a 10-20% risk of a drop in the blood leveldue to damage to the red blood cells (hemolytic anemia). Since all the research involving ribavirin wasconducted in combination with a drug called interferon, it is likely that the combination of these 2 drugs isresponsible for the hemolytic anemia. Routine blood tests will detect anemia, and ribavirin can simply bestopped if it develops.

All Medicor patients who receive ribavirin will be closely monitored by our physicians for drug side effectswith routine check-ups and comprehensive lab tests.

Why is ribavirin not being used more?Ribavirin has only undergone 1 clinical trial so far as a cancer treatment (Phase 1/2). Until it clears aPhase 3 trial, it will not be routinely used to treat cancer. Presently, there are no Phase 3 ribavirin trails.

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Is it available?Yes. Medicor has arrangements with a reputable chemical manufacturing company to supplypharmaceutical grade ribavirin for our patients. Our ribavirin is manufactured under strict regulations. Weabide by all the relevant Federal and Provincial regulations for off-label ribavirin use. Ribavirin can onlybe dispensed to patients who come under the care of our physicians.

Do I qualify for ribavirin treatment?We are accepting new patients with a documented diagnosis of cancer (any type) who:

a. have failed conventional, scientifically proven treatmentsb. have been told by their doctor that there is no safe or effective treatment for their cancer c. are unable to take conventional treatments due to their age or concurrent medical problemsd. have been treated for cancer, and have no proven options to help prevent recurrence

Presently, there is some evidence that ribavirin may work well in combination with other treatments. For patients who wish to combine ribavirin with conventional therapies, please ask your doctor to review theliterature before making a decision.

There is a theoretical increased risk of anemia if ribavirin is combined with chemotherapy, TM, rapamycinor imiquimod. We may still use such combinations depending on the circumstances. We support thepatients right to make an informed decision about their own care.

What is the cost?The cost of ongoing ribavirin treatment at Medicor is $185 per week. During the course of treatment, allmedically-necessary doctors visits, blood tests and imaging are arranged at no cost, provided you have avalid Health Card from Ontario or another province. Quebec patients must pre-pay for medical services,which can be reimbursed through the Ministre de la Sant. Ribavirin treatment may be covered byprivate medical insurance, but only a combination of ribavirin + interferon is available in Canada (e.g. DIN= 02246026). Please ask your pharmacist to check your individual plan for coverage. Ribavirin 200mgtablets are available outside Canada by prescription.

What is the duration of treatment?In order to determine if ribavirin is effective in treating your cancer, we recommend at least 2 months of treatment. If a patient responds to the drug, their therapy may continue indefinitely.

Is ribavirin cheaper if I buy it from an online pharmacy?The cost of ribavirin purchased from Medicor remains the same regardless of the dose (can range from

1000mg/day to 3000mg/day). If you buy ribavirin from an online pharmacy, the initial cost is about thesame. However, after the first 1 2 weeks of treatment when the dose increases, ribavirin will be as lowas of the cost if purchased from Medicor.

How do I become a Medicor patient?Please obtain your pathology report (confirming the diagnosis of cancer), your latest CT scan or MRI (if applicable), and your latest blood test report . If you do not have a pathology report (you did not have a biopsy),we require your specialists notes confirming the diagnosis of cancer.

You can call us at (416) 227-0037 to make an appointment to discuss your individual case. You can also contactus through our website at http://www.medicorcancer.com . A valid Health Card is required for a free consultation.Patients are only required to pay for the medication, as it is not covered by Ontario Drug Benefits. Private clinicservices are availableby request to maximize your care.