A Prospective Study of Acute Cardiovascular Effects of First-line Sunitinib in Metastatic Renal Cell Carcinoma Patients (SUnitinib Prospective CardiovasculaR Effect)

Inclusion Criteria: * Histologic diagnosis of metastatic renal cell carcinoma * Eligible to receive first-line sunitinib * Willingness to attend Cross Cancer Institute and University of Alberta for study-related assessments * Karnofsky Performance Status (KPS)82 ≥ 70 * Age ≥ 18 years of age * Adequate creatinine clearance to receive gadolinium * All patients with bone metastases are eligible; those with lesions identified at weight-bearing bones will undergo plain films to evaluate fracture risk prior to CPET; * Fluent in English language * No contraindication to MRI or other concern eg., metallic implants, claustrophobia Exclusion Criteria: * Prior systemic therapy for mRCC * Documented history of major cardiac event in last year i.e. MI, unstable angina, CABG, symptomatic CHF, CVA or TIA, or pulmonary embolism * Pregnancy * Other severe condition or abnormality that, in the judgement of the investigator or treating oncologist, would make participation in this study inappropriate * Unstable brain metastases