Rare cancers that affect children are of particular interest for capstone projects because they often receive less research funding and attention compared to more common adult cancers. Developing a deeper understanding of the molecular mechanisms, treatments, and patients’ experiences with rare pediatric cancers can help advance care for these vulnerable populations. Here are some examples of rare pediatric cancers that would be suitable topics for an in-depth senior or graduate-level capstone project:

Neuroblastoma is a rare cancer that forms in certain types of nerve tissue and most commonly appears in young children, often presenting in the adrenal glands, chest, abdomen or neck. It accounts for around 15% of all childhood cancers but less than 1% of all cancers diagnosed. Despite being rare, neuroblastoma is responsible for more deaths among children with solid tumors than any other cancer. A capstone project could explore new targeted therapies and immunotherapies in development for high-risk neuroblastoma. The student could conduct a literature review of recent clinical trials and analyze molecular markers to identify patient subgroups most likely to respond to certain treatments. Understanding the genetics and biology of neuroblastoma in more detail could help accelerate the development of personalized, precision medicine approaches.

Ewing sarcoma is the second most common bone cancer in children after osteosarcoma. It remains quite rare, accounting for less than 1% of all cancers and 3% of childhood cancers. Ewing sarcoma most often appears in bones of the pelvis, legs, chest, or spine and is characterized by translocations linking the EWS gene to an ETS family gene. A capstone project on Ewing sarcoma could comprehensively review past and current standard of care therapies, while also evaluating promising new targeted drugs and immunotherapies in preclinical and early phase clinical testing. Interviews with patients, families and clinicians could provide insights into the challenges of living with and treating this aggressive bone cancer. Identifying biomarkers for early detection and response to treatment is another important area warranting further research highlighted by such a project.

Rhabdomyosarcoma is a type of soft tissue sarcoma that develops from skeletal muscle cells or muscles in other parts of the body. It represents about 3-4% of all childhood cancers but is still considered rare. The most common locations are the head and neck region, genitourinary tract, and extremities. Subtypes include embryonal, alveolar and pleomorphic. A capstone project could focus specifically on the more aggressive alveolar subtype, analyzing its distinctive genetic mutations and exploring combination therapies to overcome resistance. The student might profile a series of alveolar rhabdomyosarcoma cases at their institution to identify clinical or molecular characteristics associated with improved outcomes. Interviews with long-term survivors could offer unique perspectives on the emotional and physical impacts as well as care needs over time.

Atypical teratoid/rhabdoid tumor (AT/RT) is an extremely rare and highly malignant type of cancerous brain tumor that primarily affects young children. It develops from cells in the central nervous system and has a very poor prognosis despite intensive multimodal therapy. AT/RT represents less than 1% of all pediatric central nervous system tumors but is the focus of considerable research efforts given its lethal nature. A project delving into the molecular hallmarks and epigenetic dysregulation characteristic of AT/RT could survey targeted agents in preclinical testing and early stage clinical trials. Collaboration with neuro-oncologists may provide access to tumor samples for exploring biomarkers of sensitivity and resistance. Investigating supportive care interventions and quality of life for patients undergoing complex treatment regimens could also yield important insights.

Wilms tumor, also known as nephroblastoma, begins in the kidneys and is the most common malignant tumor of the kidneys in children. It represents approximately 6% of all childhood cancers yet remains defined as a rare cancer. Wilms tumor is usually found in children younger than 5 years old, with 80-90% of cases arising before the age of 6. A capstone topic could extensively review protocols from cooperative clinical trials groups to analyze factors influencing event-free survival overtime. The student might conduct interviews with nursing professionals and child life specialists to gain perspective on psychosocial support needs throughout the patient journey. Exploration of genomic characterization efforts aimed at more precisely stratifying risk could also yield valuable insights for precision oncology approaches.

Rare pediatric cancers like neuroblastoma, Ewing sarcoma, rhabdomyosarcoma, AT/RT and Wilms tumor present opportunities for in-depth capstone study. Delving into disease biology, therapeutic developments, clinical research challenges, and patient/family experiences could advance understanding and care for these underserved populations. With a comprehensive literature review augmented by primary data collection, a student could produce an original research project meaningfully contributing to progress against devastating pediatric cancers.