Study of Hydroxychloroquine Before Surgery in Patients With Primary Renal Cell Carcinoma

Inclusion Criteria:

* Subjects with suspected primary or metastatic RCC (stage 1-IV) with planned nephrectomy or partial nephrectomy.
* ECOG performance status ≤1
* Normal renal, hepatic, and hematologic function at the time of enrollment as evidenced by:

  * Serum creatinine level ≤1.5 the upper limits of normal (ULN)
  * Serum total bilirubin level ≤1.5 X ULN
* White blood cell count \> or = 3.5x109/ml per ml and platelet count ≥ 100x109 per ml
* Age \>18 years.
* Ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

* Subjects who have received chemotherapy for any diagnosis within 12 months prior to study entry.
* Prior use of radiotherapy or investigational agents for RCC.
* Concurrent malignancies with evidence of active or measurable disease except non-melanoma skin cancer
* Inability to adhere to study and/or follow-up procedures
* History of allergic reactions or hypersensitivity to the study drug (hydroxychloroquine) or current therapy with the study drug for other reasons.
* Other concurrent experimental therapy.
* The effects of HC on the developing human fetus are unknown. For this reason women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation. All females of childbearing potential must have a blood test or urine study within two weeks prior to registration to rule out pregnancy. Should a woman become pregnant while participating in this study, she should inform her treating physician immediately. If a man impregnates a woman while participating in this study, he should inform his treating physician immediately as well.
* HIV-positive patients are not excluded from the study. However, for patients receiving combination anti-retroviral therapy, the potential impact of pharmacokinetic interactions with HC is unknown. Therefore, HIV-positive patients actively receiving anti-retroviral therapy are excluded from the study.
* Patients with psoriasis are ineligible unless the disease is well controlled and they are under the care of a specialist who agrees to monitor the patient for exacerbations.
* Patients requiring the use of enzyme-inducing anti-epileptic medication that includes: phenytoin, carbamazepine, phenobarbital, primidone or oxcarbazepine are excluded. Hydroxychloroquine is known to affect the CYP2D6 metabolic pathway. A list of drugs with potential interaction is included in Appendix H.
* Patients with previously documented macular degeneration or diabetic retinopathy are excluded.
* Patients with known glucose-6-phosphate dehydrogenase (GP6D) deficiency
* EKG with QTc \>500 msec at baseline (average of 3 determinations at 10 minutes interval). Subjects with ventricular pacemaker for whom QT interval is not measurable will be eligible on a case-by-case basis.