This study is a multicenter, open-label, randomized controlled trial that enrolled 116 patients with advanced or metastatic renal cell carcinoma who had failed first-line treatment with PD-1/PD-L1 monotherapy or VEGFR TKI combined with PD-1/PD-L1 therapy. Patients were randomly assigned in a 1:1 ratio to receive either the experimental group treatment with vorolanib tablets combined with everolimus or the control group treatment with sunitinib as second-line therapy until disease progression. The study aimed to evaluate the efficacy and safety of vorolanib tablets combined with everolimus as second-line therapy for renal cell carcinoma patients.

Inclusion Criteria:

1. Pathologically confirmed renal clear cell carcinoma (histological or cytological);
2. Subjects who have failed prior treatment with a single anti-PD-1/PD-L1 agent or a combination of anti-PD-1/PD-L1 and anti-VEGFR TKI;
3. Age 18 to 80 years;
4. Estimated survival exceeding 12 weeks;
5. KPS score ≥70;
6. At least one measurable lesion per RECIST 1.1 criteria, which has not received prior radiation therapy;
7. Adequate organ function levels;
8. Women of childbearing potential must have a negative serum pregnancy test within 7 days prior to randomization; all enrolled subjects (male or female) must use effective barrier contraception throughout treatment and for 4 weeks post-treatment;
9. Subjects must be capable of understanding and voluntarily signing the informed consent form, which must be signed prior to any trial procedures.

Exclusion Criteria:

1. Patients who have received one or more prior systemic anticancer treatment regimens for clear cell renal cell carcinoma;
2. Patients who have not previously received immunosuppressive therapy for advanced renal cell carcinoma;
3. Subjects currently undergoing anticancer therapy (excluding local radiotherapy for bone metastases);
4. Subjects with known hypersensitivity to similar drugs;
5. Subjects with active infectious diseases;
6. Any uncontrolled clinical condition;
7. Undergone major surgery within 4 weeks prior to enrollment;
8. History of significant psychiatric disorders that may impair understanding of informed consent or compliance with the study protocol;
9. Any condition affecting the subject's ability to swallow medication;
10. Pregnant or lactating women;
11. Subjects with severe pulmonary disease, asthma, or COPD history, with pulmonary function tests indicating moderate or greater impairment;
12. Any other factors deemed by the investigator to make the subject unsuitable for participation in the study.