For grade 3–4 AEs, sunitinib had more fatigue (RR = 0.59, 95% CI: 0.44–0.80, P= 0.0006), thrombocytopenia (RR = 0.16, 95% CI: 0.10–0.25, P <  0.00001), and neutropenia (RR = 0.23, 95% CI: 0.15–0.34, P <  0.00001), but pazopanib had significantly higher incidences of increased AST (RR = 4.46, 95% CI: 2.62–7.58, P <  0.00001) and increased ALT (RR = 4.34, 95% CI: 2.79–6.75, P <  0.00001; Table 3). This evidence concerns the gene GPT and Decreased total neutrophil count.