Patient description: 19 yo Hispanic female G1P1 at 32+ 6 weeks of gestational age presented to the OB clinic for routine follow up complaining of mild headache and leg swelling. Primary evaluation revealed BP of 146/99 and urine dipstick with 3+ proteins. Her BP and U/A were normal in previous visit. Repeat BP a few hours later is 150/100 mmHg. Laboratory studies showed a normal hematocrit, platelet count, and liver transaminase levels. She is complaining of fatigue but no fever or chills. She is also suffering of headaches with no vision changes. No shortness of breath, cough, chest pain, orthopnea and palpitations or skin rash were observed. Her physical exam was negative for abdominal pain, change in bowel habits, nausea, vomiting, dysuria, frequency, hematuria or frothy urine. Leg swelling was observed with no arthralgia or back pain. She has no specific past medical issues and only uses prenatal vitamins. Her family history is positive for DM type 2 and HTN. She is a social alcohol consumer with the negative history of smoking or drug use. She is only have one partner in past 2 years and didn't have any contraceptive methods since 2 years ago. Her BMI was 24 at the first

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Clear Cell Renal Cell Carcinoma Stage IV Renal Cell Cancer Biopsy/pathology-proven clear cell renal cell carcinoma (CCRCC) with metastases Have an Eastern Cooperative Oncology Group (ECOG) performance status =< 1 Hemoglobin >= 10 gm/dL Absolute neutrophil count (ANC) >= 1.5 x 10^9/L Platelets >= 100 x 10^9/L Total bilirubin =< upper limit of normal (ULN) Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =< ULN International normalization ratio (INR) and activated partial thromboplastin time (aPTT) < 1.2 x ULN Serum creatinine < 1.5 mg/dL or if serum creatinine > 1.5 mg/dL then calculate creatinine clearance (CrCL) > 30 mL/min Urine protein to creatinine ratio =< 1 (if urine protein creatinine ratio is > 1, then a 24-hour urine total protein must be assessed; subjects will be ineligible if the 24-hour urine protein is found to be > 1 gm)  Subjects with known brain metastases should be excluded from this clinical trial Prior VEGF targeted therapies for renal cell carcinoma (RCC) including adjuvant or neoadjuvant treatments; in phase 1 only, one prior therapy with high dose IL-2 or anti-programmed cell death (PD)-1 compound alone or in combination with cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) targeting drug is allowed on the trial Subjects diagnosed with another cancer in the past 3 years; excluding basal cell carcinoma or squamous cell carcinoma, of skin which were completely cured by resection Concurrent use of another anti-cancer drug including an investigational anti-cancer agent Major surgery within 28 days prior to treatment or major surgery planned during the next 6 months Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic or psychiatric illness/social situations that would limit compliance with study requirements History of any of the following cardio-vascular condition Myocardial infarction (MI) Unstable angina Coronary artery bypass grafting (CABG)-unless patient had a negative stress test within 6 months of screening