Cancers & treatments·Regimen libraryFirst line

NALIRIFOX

Checked 2026-09-09

Metastatic pancreatic cancer first line

One cycle

every 14 days

14-day cycle, until progressionIntravenous Continuous infusion

Components

Drug	Dose	Route	Days	Note
Liposomal irinotecan Topoisomerase I inhibitor (camptothecin prodrug)	50 mg/m²	IV	D1
Oxaliplatin Third-generation platinum (DACH-platinum)	60 mg/m²	IV	D1
Leucovorin (folinic acid)	400 mg/m²	IV	D1	2-hour infusion before fluorouracil
Fluorouracil infusion Fluoropyrimidine antimetabolite	2,400 mg/m²	IV	D1, 2 (46 h infusion)

Cycles

until progression

14-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Used in

Pancreatic ductal adenocarcinoma

Trials

NAPOLI 3

Products

NALIRIFOX (liposomal irinotecan + oxaliplatin + 5-FU/LV)Irinotecan (and liposomal irinotecan)OxaliplatinFluorouracil (5-FU)

Source

NAPOLI 3, Lancet 2023

Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.