Neoadjuvant Cabozantinib in Treating Patients With Locally Advanced Kidney Cancer

Inclusion Criteria: * Patients with renal mass consistent with a clinical stage ≥ T3Nx or TanyN+ or deemed unresectable by surgeon. * Renal cell carcinoma with clear cell component on pre-treatment biopsy of the primary tumor. * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 1. * Patients must have adequate organ and marrow function, based upon meeting all of the following laboratory criteria within 14 days before first dose of study treatment: * Absolute neutrophil count (ANC) ≥ 1500/mm³ (≥ 1.5 GI/L) without granulocyte colony-stimulating factor support. * White blood cell count ≥ 2500/mm³ (≥ 2.5 GI/L). * Platelets ≥ 100,000/mm³ (≥ 100 GI/L) without transfusion. * Hemoglobin ≥ 9 g/dL. * Alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) ≤ 3 x upper limit of normal (ULN). ALP ≤ 5 x ULN with documented bone metastases. * Total bilirubin ≤ 1.5 x ULN (for subjects with Gilbert's disease ≤ 3 x ULN). * Serum albumin ≥ 2.8 g/dl. * Serum creatinine ≤ 1.5 x ULN or calculated creatinine clearance ≥ 40 mL/min (≥ 0.67 mL/sec) using the Cockcroft-Gault equation: * Males: (140 - age) x weight (kg)/(serum creatinine \[mg/dL\] × 72) * Females: \[(140 - age) x weight (kg)/(serum creatinine \[mg/dL\] × 72)\] × 0.85 * Urine protein/creatinine ratio (UPCR) ≤ 1 mg/mg (≤ 113.2 mg/mmol). * No hormonal therapy, chemotherapy, immunotherapy, or any other systemic therapy for a malignancy, in the 5 years prior t…