Summary The purpose of this study is to evaluate the safety and efficacy of carbozantinib to reduce pain in this patient group compared to mitoxantrone plus prednisone.  Eligible patients will be randomly assigned to one of the above treatment arms.  Patients will return to the clinic every 3 weeks for the IV infusion treatment and safety assessments.  Patients will self report pain information by answering a health related quality of life survey by automated phone system.  The estimated time of participation on this study is 12 months.