Safety and Toxicity Study of Sorafenib in Patients With Kidney Cancer

Inclusion Criteria:

   1. Histologically- or cytologically-confirmed metastatic or unresectable renal cell
   carcinoma (RCC).

   2. must have a component of conventional clear cell renal carcinoma.

   3. No more than one prior systemic therapy.

   4. No prior vascular endothelial growth factor receptor agents.

   5. Prior palliative radiotherapy in metastatic lesion(s) is permitted, provided the
   subject has at least one measurable and/or evaluable lesion(s) that has not been
   irradiated.

   6. All major surgery of any type and/or radiotherapy must be completed at least 4 weeks
   prior to Day 1 dosing. Patients must have recovered from surgery and/or radiotherapy
   toxicity prior to Day 1 dosing.

   7. Measureable disease by RECIST criteria

   8. Karnofsky performance status at least 70% or ECOG not more than 2

   9. Ability to give written informed consent

10. At least 18 years old

11. Negative pregnancy test within 7 days of Day 1 dosing (female subjects of childbearing
   potential)

12. Sexually active fertile subjects must agree to use an accepted method of contraception
   during the course of the study for 3 months thereafter.

13. ANC at least 1,500/uL

14. Platelet count at least 100,000/uL

15. AST/ALT not more than 2.5 times the upper limit of normal (ULN)

16. Alkaline phosphatase not more than 2.5 x ULN

17. Serum bilirubin not more than 1.5 x ULN

18. Amylase/Lipase within normal range

19. Urinalysis not more than 1+ protein

20. Serum creatinine not more than 1.5 x ULN

21. No active ischemia by ECG

22. Echocardiogram or MUGA ejection fraction at least 40%

Exclusion Criteria:

   1. Ongoing hemoptysis

   2. Cerebrovascular accident within 12 months

   3. Peripheral vascular disease with claudication on less than 1 block

   4. History of clinically significant bleeding

   5. Malignancy with true papillary/sarcomatoid features without any clear cell component

   6. Chromophobe

   7. Oncocytoma

   8. Collecting duct tumors

   9. Transitional cell carcinoma

10. Deep venous thrombosis or pulmonary embolus within one year of consent

11. Ongoing need for full-dose oral or parenteral anticoagulation. Low dose coumadin (1
   mg) for maintenance of catheter patency or daily prophylactic aspirin is allowed

12. Subjects with evidence of current central nervous system (CNS) metastases

13. MRI or CT scan of the brain (with contrast, if possible) within 28 days prior to Day 1
   dosing

14. Significant cardiovascular disease defined as congestive heart failure (New York Heart
   Association Class II, II or IV)

15. Angina pectoris requiring nitrate therapy

16. Myocardial infarction within the last 6 months

17. Uncontrolled hypertension (defined as blood pressure at least 160 mmHg systolic or at
   least 90 mmHg diastolic on medication)

18. Ongoing requirement for systemic corticosteroid therapy (except replacement therapy
   for adrenal insufficiency). Topical and/or inhaled steroids are allowed.

19. Uncontrolled psychiatric disorder

20. Delayed healing of wounds, ulcers, and/or bone fractures

21. Prior malignancy (EXCEPTIONS: adequately-treated basal cell or squamous cell skin
   cancer or any other cancer for which chemotherapy has been completed > 5 years ago and
   from which the patient has been disease-free for > 5 years)

22. Pregnant

23. Currently lactating

24. Currently using St John's Wort (an herb)