Comprehensive Systematic Review of Pazopanib’s Therapeutic Efficacy and Safety Profile in Renal Cell Carcinoma Management

Background Renal cell carcinoma (RCC) treatment has evolved substantially with the introduction of targeted therapies. Pazopanib (PZP), an oral multikinase inhibitor, is approved for the first‐line treatment of advanced/metastatic RCC and has demonstrated clinical efficacy in prolonging progression‐free survival (PFS) and overall survival (OS). Compared to other targeted agents, PZP is associated with a more favorable safety profile. However, its real‐world performance and clinical utility across diverse populations, particularly in comparison with existing therapies, remain insufficiently explored. Methods This systematic review adhered to PRISMA principles to assess publications published from 2010 to 2023. A thorough literature review was performed using Google Scholar, ScienceDirect, PubMed, Medline, Cochrane, and Scopus databases. The studies evaluated PZP’s PFS, OS, and safety profile. Results PZP improved PFS compared to placebo, with a median PFS of 9.2 months versus 4.2 months. Compared to sunitinib, PZP had comparable efficacy (PFS: 8.4 vs. 9.5 months) but demonstrated fewer severe AEs. PZP demonstrated an OS of 22.9 months compared to 20.5 months for placebo. Grade 3/4 AEs were reported in 33% of PZP‐treated patients. Common toxicities included hypertension and diarrhea (each 4%), and serious cardiovascular events were observed in 3% of patients, which is less than other treatments. Elevations in liver enzymes alanine aminotransferase/aspartate aminotransferase (ALT/AST) were among the most frequent laboratory abnormalities. Compared to sunitinib, PZP had lower rates of hematological toxicities such as neutropenia and thrombocytopenia. Conclusion PZP offers substantial benefits in PFS compared to placebo, with tolerable safety profiles. While its efficacy relative to sunitinib is similar, PZP’s lower hematologic toxicity profile may provide an advantage for specific patient populations. PZP can be considered a viable treatment option for RCC with manageable side effects. However, continued evaluation of its long‐term safety and real‐world outcomes is warranted to guide patient selection and optimize treatment strategies.