Inclusion Criteria:

- Patients with histologically or cytologically confirmed clear-cell mRCC with
progressive disease and not amenable to or progressive on or within 6 months of
stopping treatment with a VEGF receptor tyrosine kinase inhibitor (sunitinib (or
pazopanib) ± sorafenib).

- Prior therapy with cytokines (i.e. IL-2, interferon) and/or VEGF-ligand inhibitors
(i.e. bevacizumab) is permitted.

- Patients with brain metastases are eligible if they have been stable for at least two
months post-radiation therapy or surgery.

- Aged 18 years or older.

- No other current malignant disease, except for basal cell carcinoma of the skin.

- WHO performance status 0-2.

- Life expectancy of at least 12 weeks.

- Adequate hematologic function: ANC ≥ 1.5 x 109/L, platelets ≥ 100 x 109/L, Hb ≥ 6.0
mmol/L.

- Adequate hepatic function: serum bilirubin ≤ 1.5 x ULN, ALT and AST ≤ 2.5 x ULN (or ≤
5 times ULN if liver metastases are present).

- Adequate renal function: calculated creatinine clearance ≥ 50 ml/min.

- Measurable or evaluable disease as defined by RECIST 1.1.

- Patients with reproductive potential must use effective contraception. Female
patients must have a negative pregnancy test.

- Signed informed consent.

- Able to receive oral medication.

Exclusion Criteria:

- Patients currently receiving chemotherapy, immunotherapy, or radiotherapy or who have
received these ≤ 4 weeks prior to visit 1. The wash-out period for sunitinib or
sorafenib is at least 2 weeks from the first dose of the study medication.

- Known human immunodeficiency virus (HIV) or other major immunodeficiency.

- Immunosuppressive agents within 3 weeks of study entry, except for low dose
corticosteroids when given for disorders such as rheumatoid arthritis, asthma, or
adrenal insufficiency. Topical or inhaled corticosteroids are permitted.

- Patients with an active bleeding diathesis or on oral anti-vitamin K medication.

- Patients with untreated CNS metastases with clinical symptoms or who have received
treatment for CNS metastases within 2 months of study entry. Patients with treated
CNS metastases, who are neurologically stable and off of corticosteroids for more
than 2 months prior to study entry are eligible to enter the study.

- Active infection or serious intercurrent illness, except asymptomatic bacteriuria.

- Presence of unstable angina, recent myocardial infarction (within the previous 6
months), or use of ongoing maintenance therapy for life-threatening ventricular
arrhythmia.

- Macroscopic hematuria

- Prior therapy with mTOR inhibitors. 10. Known hypersensitivity to everolimus or other
rapamycins (sirolimus/temsirolimus) or to its excipients.

- Pregnant or nursing women, or women who were of childbearing potential and who were
not utilizing an effective contraceptive method. A woman of childbearing potential is
defined as a female who is biologically capable of becoming pregnant. Men with
partners of childbearing potential not using an effective method of contraception.
(Use of effective contraceptives must continue for 3 months after the last dose of
everolimus).

- Presence of any significant central nervous system or psychiatric disorder(s) that
would hamper the patient's compliance.

- Uncontrolled diabetes as defined by fasting serum glucose > 2 ULN, severely impaired
lung function.

- Cirrhosis/chronic active hepatitis/chronic persistent hepatitis, history of HCV
infection (for hepatitis screening indications see section 3.3).

- Drug or alcohol abuse.

- Any other major illness that, in the investigator's judgment, substantially increased
the risk associated with the subject's participation in the study.