Regulatory and clinical challenges persist in the rare disease landscape. The FDA faces calls to adopt fit-for-purpose pathways to mitigate costly delays affecting ultraprecise treatments. Meanwhile, Stealth BioTherapeutics' rare disease drug faces uncertain approval prospects after a refuse-to-file decision, putting the company's future at risk. Additionally, bluebird bio's gene therapy Skysona faces FDA restrictions due to cancer risks observed in trial patients, spotlighting safety concerns. These developments highlight evolving regulatory dynamics influencing rare disease therapeutics.