Inclusion Criteria:

1. Histologically or cytologically confirmation of renal cell carcinoma without a clear
cell histologic component, e.g., papillary type, chromophobe type, or collecting duct
type

2. Patients with stage IV or recurrent disease not amenable to surgery, radiotherapy, or
combined modality therapy with curative intent.

3. Measurable disease according to RECIST criteria

4. ECOG performance status 1 or better

5. Age 18 years or older

6. Adequate cardiac function

7. Adequate bone marrow, hepatic, and renal function

8. Life expectancy of ≥ 3 months

9. Singed and dated informed consent of document indicating that the patient (or legally
acceptable representative) has been informed of all pertinent aspects of the trial
prior to enrollment

Exclusion Criteria:

1. Clear cell type renal cell carcinoma or sarcomatoid carcinoma without any clue to the
primary type

2. Diagnosis of any serious secondary malignancy within the last 2 years, except for
adequately treated basal cell or squamous cell carcinoma of skin, or in situ
carcinoma of cervix uteri

3. Hypertension that cannot be controlled by medications (blood pressure > 150/90 mmHg
despite optimal medical therapy)

4. Treatment with anticonvulsant agents and treatment with therapeutic doses of coumadin
currently or within 2 weeks prior to first day of sunitinib administration. Low dose
coumadin for DVT prophylaxis is permitted (up to 2 mg/day).

5. Pregnancy or breast feeding.

6. Other severe acute or chronic medical or psychiatric condition

7. Prior treatment on sunitinib, sorafenib, or bevacizumab.