{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:55:35Z","timestamp":1781517335364,"version":"3.54.1"},"reference-count":46,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Neuroendocrine tumours (NETs) are heterogeneous neoplasms with several treatment options. Response rates, disease progression, and haematological toxicities can limit the use of some indicated treatments. Case Presentation: A 73-year-old woman with a well-differentiated grade 2 pancreatic NET (Ki-67 18%) underwent surgical resection and later developed hepatic recurrence. First-line treatment with sunitinib plus octreotide achieved temporary disease stabilisation. Upon progression, peptide receptor radionuclide therapy (PRRT) with 177Lu-DOTATATE was initiated, resulting in stable disease but complicated by grade 3 thrombocytopenia. Two years later, PRRT retreatment was performed due to disease progression, which led to grade 4 thrombocytopenia. Further treatments with capecitabine and everolimus were limited by progression and significant thrombocytopenia. Therapy was switched to streptozocin plus 5-fluorouracil, which resulted in recovery of platelet counts, absence of haematological toxicity, and a sustained radiologic response until March 2025, when she presented with hepatic progression. FOLFOX chemotherapy was initiated but discontinued after one cycle due to severe thrombocytopenia. Deterioration in general condition ultimately led to supportive care and death in March 2026. Conclusions: This case highlights the risk of cumulative haematological toxicity with PRRT, particularly in retreatment settings. Careful patient selection and close monitoring are essential. Streptozocin-based chemotherapy may be an effective and well-tolerated alternative for patients with treatment-limiting toxicity.<\/jats:p>","DOI":"10.3390\/jcm15124628","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:57:58Z","timestamp":1781513878000},"page":"4628","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Review of Haematological Toxicities in Well-Differentiated Neuroendocrine Tumours: A Case Report and Comprehensive Review of the Literature"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7265-0251","authenticated-orcid":false,"given":"David","family":"Gomez","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario de Navarra (HUN)-IdiSNA, Calle de Irunlarrea, 3, 31008 Pamplona-Iru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9419-6232","authenticated-orcid":false,"given":"Ram\u00f3n","family":"Salazar","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Oncobell Program IDIBELL Institut Catal\u00e0 D\u2019Oncologia (ICO) Duran I Reynals Hospital, Clinical Sciences Department, Bellvitge Campus, University of Barcelona, Centro de Investigaci\u00f3n Biom\u00e9dica en Red de C\u00e1ncer, 08007 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4592-3813","authenticated-orcid":false,"given":"Paula","family":"Jim\u00e9nez Fonseca","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Custodio","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario La Paz, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9237-8614","authenticated-orcid":false,"given":"Beatriz","family":"Ant\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON M5G 2M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaya","family":"Sadaba","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario de Navarra (HUN)-IdiSNA, Calle de Irunlarrea, 3, 31008 Pamplona-Iru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1268-4588","authenticated-orcid":false,"given":"Marta","family":"Benavent","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario Virgen Del Roc\u00edo, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Elsa","family":"Huerta","sequence":"additional","affiliation":[{"name":"Translational Medical Oncology Unit, Navarrabiomed-Instituto de Investigaci\u00f3n Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Silvia","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Nurse, Hospital Universitario de Araba, 01009 Vitoria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itziar","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Nurse, Hospital Universitario de Araba, 01009 Vitoria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0408-6871","authenticated-orcid":false,"given":"Nieves","family":"Mart\u00ednez Lago","sequence":"additional","affiliation":[{"name":"Medical Oncology Department, Santiago de Compostela University Clinical Hospital (CHUS) and Health Research, Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Hernando","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario Vall D\u2019Hebron, Vall d\u2019Hebron Institute of Oncology, 08035 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Vera","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Hospital Universitario de Navarra (HUN)-IdiSNA, Calle de Irunlarrea, 3, 31008 Pamplona-Iru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2565","DOI":"10.1016\/j.ejca.2013.02.029","article-title":"Rare Neuroendocrine Tumours: Results of the Surveillance of Rare Cancers in Europe Project","volume":"49","author":"Trama","year":"2013","journal-title":"Eur. 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