How would you treat a patient with metastatic clear cell renal cancer who has progressed on immunotherapy and developed bleeding on cabozantinib?

This is not an uncommon situation. Any VEGFR inhibitor can indeed raise the risk of bleeding. An answer depends on the details of the bleeding-like one episode vs ongoing chronic bleeding, severity, arterial vs venous, location, GI vs CNS vs elsewhere, other contributing factors like anti-coagulants...