Sunitinib Plus Temsirolimus in Patients With Renal Cell Cancer (RCC)

Inclusion Criteria:

1. Patients with confirmed metastatic RCC of any histological subtype
2. Patients must have evaluable disease
3. Age \>/= 18 years. Because no dosing or adverse event data are currently available on the use of these targeted agents in patients \< 18 years of age, children will be excluded from this study. RCC in patients \< 18 is exceedingly rare in any event.
4. Eastern Cooperative Oncology Group (ECOG) performance status \</= 1
5. Patients must have adequate organ and marrow function within 14 days as defined below: a) Absolute neutrophil count \>/= 1,500/µL; b) Platelet count \>/= 100,000/µL; c) Hemoglobin \>/= 9.0 g/dL (may be transfused to maintain or exceed this level); d) Total bilirubin \</= 2.0 mg/dl; e) Albumin \> 2.5 g/dL; f) Serum creatinine \</= 2.0 mg/dl; g) AST (SGOT) and ALT (SGPT) \</= 2.5 times the institutional upper limit of normal for subjects without evidence of liver metastases; h) AST (SGOT) and ALT (SGPT) \</= 5 times the institutional upper limit of normal for subjects with documented liver metastases
6. Female patients of childbearing potential must have a normal serum beta human chorionic gonadotropin (beta-hCG) within 24 hours prior to beginning treatment on the study due to the possible teratogenic effect.
7. Patients of child fathering or childbearing potential must agree to practice a form of medically acceptable birth control while on study
8. Patients must give written informed consent prior to initiation of study-related procedures. Patients with a history of major psychiatric illness must be judged able to fully understand the investigational nature of the study and the risks associated with the therapy
9. Patients must be able to swallow pills
10. Both men and women and members of all races and ethnic groups are eligible for this trial

Exclusion Criteria:

1. No prior malignancy is allowed, except for non-melanoma skin cancer, in situ carcinoma of any site, or other cancers for which the patient has been definitively treated and disease free for 2 years. Patients with controlled brain metastases are eligible.
2. Patients must not be scheduled to receive another anticancer drug while on this study. Patients are permitted to be on concomitant bisphosphonates or megestrol acetate
3. Patients must not have had a stroke or TIA within 6 months
4. Patients must not have uncontrolled infections that could be worsened by anticancer therapy or interfere with this study
5. Patients must not have clinically significant cardiovascular disease, defined as myocardial infarction (or unstable angina) within 6 months, New York Heart Association (NYHA) Grade II or greater congestive heart failure, serious cardiac dysrhythmia refractory to medical management, or peripheral vascular disease (Grade III or greater)
6. Patients must not have uncontrolled hypertension, defined as \> 140/90 in either systolic or diastolic component (treatment of hypertension with medications is permitted)
7. Symptomatic peripheral vascular disease
8. Pregnant women are excluded from this study because of the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with these agents, breast-feeding should be discontinued if the mother is enrolled on this trial
9. Patients with immune deficiency are at increased risk of lethal infections when treated with marrow-suppressive therapy. In addition, HIV-positive patients receiving combination anti-retroviral therapy are excluded from the study because of possible pharmacokinetic interactions with some of these agents
10. Patients must not have a clinical history of coagulopathy or bleeding diathesis
11. Concomitant treatment with rifampin, St. John's wort, or the cytochrome p450 enzyme-inducing antiepileptic drugs (phenytoin, carbamazepine or Phenobarbital) or CYP3A4 inhibitors is not recommended on this study.
12. Patients with significant baseline proteinuria defined as \> grade 2 by screening U/A will be excluded if they have \> 2 g protein by urine protein over creatinine (UPC) ratio
13. Major surgical procedure, open biopsy, or significant traumatic injury within 28 days prior to study enrollment or anticipation of need for major surgical procedure during the course of the study
14. Core biopsy or other minor surgical procedure, excluding placement of a vascular access device within 7 days prior to study enrollment
15. History of abdominal fistula, gastrointestinal perforation, or intra-abdominal abscess within 6 months prior to study enrollment
16. Non-healing wound, ulcer, or bone fracture
17. Known hypersensitivity to any component of sunitinib malate, or temsirolimus