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 daysComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
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
Products
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.
Other regimens for these cancers
mFOLFOX6
Adjuvant stage III colon (6 months) or metastatic colorectal and upper GI first line
every 14 days × 12
FOLFIRINOX
Metastatic pancreatic cancer, performance status 0-1
every 14 days × 12
mFOLFIRINOX (adjuvant)
Resected pancreatic cancer, fit patients, started within 12 weeks of surgery
every 14 days × 12
Gemcitabine + nab-paclitaxel
Metastatic pancreatic cancer first line; adjuvant option when FOLFIRINOX is not tolerated
every 28 days
Gemcitabine monotherapy
Frail patients or adjuvant when combinations are not tolerated
every 28 days × 6
NALIRIFOX
Metastatic pancreatic cancer first line
every 14 days
Olaparib maintenance
Newly diagnosed BRCA-mutant advanced ovarian cancer after platinum response (2 years); recurrent platinum-sensitive disease; BRCA/HRR-mutant prostate; germline BRCA pancreatic after platinum
every 28 days × 2
GEMOX
Advanced biliary tract cancer when cisplatin is unsuitable; also used in pancreatic cancer and some lymphomas
every 14 days