CRLX101(NLG207) in Combination With Bevacizumab for Metastatic Renal Cell Carcinoma (mRCC) Versus Standard of Care (SOC)

Inclusion Criteria:

* Must have histologically confirmed renal cell carcinoma of any pathologic subtype.
* Must have unresectable metastatic disease, and have tumor(s) present that is (are) evaluable by the RECIST, v1.1; may have spinal-associated metastases but must have concluded dexamethasone therapy and be evaluated by the Investigator to have stable CNS disease.
* Must have received 2 or 3 prior lines of conventional molecularly targeted therapy
* Must have full recovery from any toxicities from prior therapy CTCAE Grade 1 or less with the exception of Grade 2 alopecia) prior to randomization.
* ECOG performance status 0 or 1.
* Age 18 years and older.
* Life expectancy of at least 3 months.
* Must have normal organ and marrow function reported within 14 days prior to randomization
* Ability to understand and willingness to sign a written informed consent document.
* Able to comply with study visit schedule and assessments.

Exclusion Criteria:

* Any conventional molecularly targeted therapy within 2 weeks or, chemotherapy or radiotherapy within 2 weeks (local) or 4 weeks (systemic) prior to entering the study.
* Failure to recover to grade 1 or less all prior adverse events.
* Any major surgery within 4 weeks of study randomization.
* Any prior treatment with topoisomerase I therapy.
* Prior treatment with any drugs or therapies that will be administered during the course of this trial including CRLX101, any topoisomerase 1 inhibitor, bevacizumab or the conventional molecularly targeted agent intended for use as standard of care treatment.
* Patients receiving any other current investigational therapeutic agent.
* Other active malignancies
* Patients with brain metastasis treated or untreated, or other CNS disease
* Any clinically significant cardiac disease defined as NYHA class III or IV.
* Uncontrolled hypertension
* Uncontrolled concurrent illness
* History of non-healing wounds or ulcers.
* Pregnancy, or inadequate contraception for men or women of childbearing age, or lactating / breast-feeding
* Patients with known HIV or with solid organ transplant