Patient description: The patient is a 63-year-old man presenting to the Emergency Department with a history of acute urinary retention in the past 2 days. Abdominopelvic CT scan revealed a large prostate and a bladder filled with urine. He is a candidate for urethral catheterization and TURP. Further evaluation revealed: Post-void residual: 71 mL Prostate volume (TRUS): 63 mL Prostate-specific antigen (PSA) level: 3.5 ng/mL His recent blood chemistry (3 days ago) was normal: Hgb: 13.6 g/dl WBC: 133000 /mm3 Plt: 370000 /ml PT: 12 second PTT: 34 second INR: 0.9 Creatinine: 0.5 mg/dl BUN: 10 mg/dl U/A: Color: yellow Appearance: cloudy PH: 5.3 Specific gravity: 1.010 Glc: 100 Nitrite: negative Ketone: none Leukocyte esterase: negative RBC: negative WBC: 2 WBCs/hpf U/C: negative

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Renal Cell Carcinoma Histological or cytological proof of component (any percent) of clear cell RCC (renal cell carcinoma) Metastatic or locally advanced unresectable RCC. NOTE: Prior nephrectomy is not mandatory Progressive disease after 1-2 prior VEGF-directed tyrosine kinase inhibitors (TKIs) Measurable disease according to and obtained by imaging within 30 days prior to registration for protocol therapy Written informed consent and HIPAA authorization for release of personal health information Age > 18 years at the time of consent Females of childbearing potential and males must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 4 weeks after treatment discontinuation Females of childbearing potential must have a negative pregnancy test within 7 days prior to registration for protocol therapy  No active brain metastases. Patients with neurological symptoms must undergo a head CT scan or brain MRI to brain metastasis within 30 days prior to registration on protocol therapy. NOTE: A patient with prior brain metastasis are eligible if they have completed their radiation treatment for brain metastasis ≥30 days prior to registration for protocol therapy, are off steroids, and are asymptomatic No other currently active malignancy No treatment with any investigational agent within 14 days prior to registration for protocol therapy. NOTE: If treated with investigational agent within 14 days prior to registration, AE must be resolved back to baseline Prior cancer treatment must be completed at least 14 days prior to registration for protocol therapy and the patient must have recovered from the acute toxic effects of the regimen. With the exception of Bevacizumab treatment, which must be completed 30 days prior to registration for protocol therapy Prior radiation therapy to < 25% of the bone marrow [see bone marrow radiation chart in the study procedure manual (SPM)] allowed if completed within 30 days prior to registration for protocol therapy Corrected QT interval (QTc) ≤ 450 msec at least 7 days prior to registration for protocol therapy No clinically significant infections as judged by the treating investigator No liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis No collecting duct, medullary or sarcomatoid histology No prior treatment with temsirolimus or everolimus in the phase II component of the study. NOTE: Prior treatment with these agents is permitted in the phase I component of the study