• Patients must be \>= 12 months at enrollment

• Patients must have a body surface area (BSA) \>= 0.53 m\^2

• Histologically confirmed unresectable or metastatic translocation morphology renal cell carcinoma diagnosed using World Health Organization (WHO)-defined criteria. Patients may be newly diagnosed or have received prior cancer therapy

‣ Patients must have had histologic verification of the malignancy

⁃ Patients must have measurable disease, documented by clinical, radiographic, or histologic criteria as defined by Response Evaluation Criteria in Solid Tumors (RECIST) version (v)1.1

⁃ Patients must have a tumor showing the appropriate morphologic appearance, and either confirmed TFE3 nuclear protein expression by immunohistochemistry with appropriate positive and negative controls performed at a Clinical Laboratory Improvement Act (CLIA)-certified laboratory, or evidence of TFE3 or TFEb translocation by either fluorescence in situ hybridization (FISH) or reverse transcriptase- polymerase chain reaction (RT-PCR) performed at a CLIA-certified laboratory. For TFE3 immunohistochemistry, any nuclear positivity in the presence of appropriate positive and negative controls should be considered as evidence of TFE3 immunohistochemical expression. NOTE: If the institution is unable to perform these studies, unstained slides may be submitted to Dr. Elizabeth Perlman, who will perform TFE3 analysis at no charge. The slide will be returned to the referring institution for local evaluation, to be included in their institutional report

• Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1 or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\< 16 years of age

• Patients must have a life expectancy of \>= 8 weeks

• Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering this study

‣ Myelosuppressive chemotherapy: Must not have received within 2 weeks of entry onto this study (6 weeks if prior nitrosourea)

⁃ Immunotherapy: Must not have received within 4 weeks of entry onto this study

⁃ Biologic (anti-neoplastic agent): At least 7 days since the completion of therapy with a biologic agent

⁃ Radiation therapy (RT): \>= 2 weeks for local palliative RT (small port); \>= 6 months must have elapsed if prior craniospinal RT or if \>= 50% radiation of pelvis; \>= 6 weeks must have elapsed if other substantial bone marrow (BM) radiation

• Peripheral absolute neutrophil count (ANC) \>= 1000/uL (performed within 7 days prior to enrollment)

• Platelet count \>= 75,000/uL (transfusion independent) (performed within 7 days prior to enrollment)

• Hemoglobin \>= 8.0 g/dL (may receive red blood cell \[RBC\] transfusions) (performed within 7 days prior to enrollment)

• Urine protein: =\< 30 mg/dL in urinalysis or =\< 1+ on dipstick, unless quantitative protein is \< 1000 mg in a 24 hours (h) urine sample (performed within 7 days prior to enrollment)

• For patients \< 18 years of age: Serum creatinine =\< 1.5 x upper limit of normal (ULN), or measured or calculated creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 60 mL/min/1.73 m\^2 for patient with creatinine levels \> 1.5 x institutional ULN, or a serum creatinine based on age/gender as follows (performed within 7 days prior to enrollment):

‣ 1 to \< 2 years - 0.6 mg/dL (male, female)

⁃ 13 to \< 16 years - 1.5 mg/dL (male), 1.4 mg/dL (female)

⁃ \>= 16 years - 1.7 mg/dL (male), 1.4 mg/dL (female)

⁃ Creatinine clearance should be calculated per institutional standard

• For patients \>= 18 years of age: Serum creatinine =\< 2 x ULN, or measured or calculated creatinine clearance or radioisotope GFR \>= 40 mL/min/1.73 m\^2 for patient with creatinine levels \> 2 x institutional ULN (performed within 7 days prior to enrollment)

‣ Creatinine clearance should be calculated per institutional standard

• Serum total bilirubin =\< 1.5 x ULN for age, or direct bilirubin =\< ULN for patients with total bilirubin levels \> 1.5 X ULN (performed within 7 days prior to enrollment)

• Serum glutamic-oxaloacetic transaminase (SGOT) (aspartate aminotransferase \[AST\]) or serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) \< 3 x ULN for age (performed within 7 days prior to enrollment)

• Albumin \> 2.5 mg/dL (performed within 7 days prior to enrollment)

• Shortening fraction of \>= 27% by echocardiogram, or

• Ejection fraction of \>= 50% by radionuclide angiogram

• No history of myocardial infarction, severe or unstable angina, or peripheral vascular disease

• Corrected QT (QTc) =\< 480 msec. Note: Patients with grade 1 prolonged QTc (450-480 msec) at the time of study enrollment should have correctable causes of prolonged QTc addressed if possible (i.e., electrolytes, medications)

• International normalized ratio (INR) or prothrombin time (PT) =\< 1.5 X ULN. However, if patient is receiving anticoagulant therapy, PT or partial thromboplastin time (PTT) should be within therapeutic range of intended use of anticoagulants

• Activated partial thromboplastin time (aPTT) =\< 1.5 X ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants

• A baseline blood pressure (BP) =\< the 95th percentile for age, height, and gender for patients \< 18 years old, or =\< 150 mmHg (systolic) and =\< 90 mmHg (diastolic) for patients \>= 18 years old

‣ Note: 2 serial blood pressures should be taken at least 1 hour apart and averaged to determine baseline BP

• Patients are eligible if on stable doses (\>= 7 days) of anti-hypertensive medications with a baseline BP meeting the criteria above