Cancers & treatments·Regimen libraryLater line

OFF (oxaliplatin, folinic acid, fluorouracil)

Checked 2026-09-09

Second-line metastatic pancreatic cancer after gemcitabine (CONKO-003)

Also called OFF.

One cycle

every 42 days

42-day cycle, until progressionIntravenous Continuous infusion

Components

Drug	Dose	Route	Days
Oxaliplatin Third-generation platinum (DACH-platinum)	85 mg/m²	IV	D8, 22
Folinic acid	200 mg/m²	IV	D1, 8, 15, 22
Fluorouracil Fluoropyrimidine antimetabolite	2,000 mg/m²	IV	D1, 8, 15, 22 (24 h infusion)

Cycles

until progression

42-day cycle

Emetogenicity

Moderate (30-90%)

G-CSF

Not routine

Notes

Adding oxaliplatin to fluorouracil prolonged survival in the second line; liposomal irinotecan with fluorouracil (NAPOLI-1) is the other second-line standard.

Used in

Pancreatic ductal adenocarcinoma

Products

OxaliplatinFluorouracil (5-FU)

Source

Oettle (CONKO-003), JCO 2014: OFF versus folinic acid and fluorouracil after gemcitabine

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.