Sunitinib Before and After Surgery in Treating Patients With Stage IV Kidney Cancer

DISEASE CHARACTERISTICS:

Diagnosis of renal cell carcinoma

AJCC stage IV disease
Radiographic evidence of disease for which cytoreductive nephrectomy is deemed to be clinically indicated AND for which preoperative embolization is not deemed necessary by the surgeon
No history or clinical evidence of brain metastases

PATIENT CHARACTERISTICS:

ECOG performance status 0-1
WBC ≥ 3,000/mm³
Absolute granulocyte count ≥ 1,500/mm³
Platelet count ≥ 100,000/mm³
Serum creatinine ≤ 2.0 times upper limit of normal (ULN) OR serum creatinine clearance ≥ 40 mL/min
Total bilirubin ≤ 1.5 times ULN (< 3.0 times ULN in the presence of Gilbert's disease)
AST/ALT ≤ 2.5 times ULN (≤ 5.0 times ULN in the presence of liver metastases)
INR ≤ 1.5*
PTT normal*
Not pregnant or nursing
Negative pregnancy test
Fertile patients must use effective contraception
No pre-existing thyroid abnormality with thyroid-stimulating hormone that cannot be maintained in the normal range with medication
No hypertension that cannot be controlled by medications (i.e., diastolic BP ≥ 100 mm Hg despite optimal medical therapy)
No ongoing cardiac dysrhythmias ≥ grade 2 (according to NCI CTCAE v3.0)
No other concurrent malignancies

No concurrent serious illness including, but not limited to, any of the following:

Ongoing or active infection requiring parenteral antibiotics
Clinically significant cardiovascular disease (e.g., uncontrolled hypertension, myocardial infarction, or unstable angina)
New York Heart Association class II-IV congestive heart failure
Serious cardiac arrhythmia requiring medication
Peripheral vascular disease ≥ grade 2 within the past year
Psychiatric illness/social situation that would limit compliance with study requirements NOTE: *Patients who are taking warfarin must have documentation of an INR ≤ 1.5 and PTT normal prior to the initiation of anticoagulation to rule out a baseline coagulopathy

PRIOR CONCURRENT THERAPY:

At least 2 weeks since prior radiotherapy and recovered
Prior radiotherapy to a symptomatic site of metastatic disease is allowed
No prior systemic therapy
No concurrent cytochrome P450 enzyme-inducing antiepileptic drugs (e.g., phenytoin, carbamazepine, or phenobarbital), rifampin, or Hypericum perforatum (St. John's wort)
No other concurrent investigational agents