Aim of the studyNeuroendocrine tumours are highly vascular neoplasms known to overexpress vascular endothelial growth factor (VEGF) and its receptor. Bevacizumab, an inhibitor of VEGF, was assessed in combination with chemotherapy in pancreatic neuroendocrine tumour (P-NET). Patients and methodsBETTER was a multicentre, open-label, non-randomised, two-group phase II trial. Patients with progressive metastatic, well-differentiated P-NET received a minimum of 6month treatment of bevacizumab at 7.5mg/kg IV on d1 q3w with 5-FU at 400mg/m2/day and streptozocin at 500mg/m2/day IV from d1 to d5 every 42days. The primary end-point was progression-free survival (PFS); secondary end-points were overall survival (OS), overall response rate, safety and quality of life. ResultsA total of 34 patients were included. Median age was 55years, 65% of patients were men, 97% had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 and 97% had a Ki-67 proliferative index of <15%. After a maximum of 24month follow-up per patient, the median PFS assessed by investigators was 23.7months [95% confidence interval (CI): 13.1; not reached], 19 (56%) patients had a partial response and 15 (44%) had stable disease as best response. OS rate at 24months was 88%. The most frequently reported grade 3–4 adverse events were hypertension (21% patients), abdominal pain (12%) and thromboembolic events (9%). ConclusionBevacizumab with 5-FU/streptozocin in the treatment of pancreatic NETs seems to be feasible with a PFS of 23.7months, which deserves further attention. No unexpected toxicity was observed.