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Peanut allergy can lead to life-threatening reactions upon accidental ingestion of peanuts. Notwithstanding, treatment options are limited. The standard of care is to reduce accidental exposure by a strict peanut avoidance; however, this approach can be a major source of stress, uncertainty, and result in both dietary and social restrictions [1]. Peanut oral allergen immunotherapy (peanut-OIT) has garnered substantial expectations, especially the development of standardized products, a concern highlighted by EAACI guidelines as early as 2018. By modulating the immune response through a controlled, incremental exposure to peanut protein, peanut-OIT has the potential to induce desensitization and reduce the severity of reactions caused by accidental exposure. In the last issue of ALLERGY, the authors A. Arnau-Soler et al. [2] provided valuable insights into the molecular drivers of peanut-OIT responsiveness. Using multi-omics profiling of peanut-stimulated PBMCs, they identified immune, transcriptomic, and epigenetic changes distinguishing complete responders from incomplete peanut-OIT responders [2]. Peanut-OIT has gained a solid evidence-based position in clinical guidelines [3] thanks to data also from admission trials for the first authorized product [4, 5]. Notwithstanding the favorable scientific situation of peanut-OIT, Stallergenes Greer will discontinue the commercialization of Palforzia (Peanut [Arachis hypogaea] Allergen Powder-dnfp) as of July 31, 2026 (https://www.palforzia.com). On their US website, they state to continue to meet all regulatory obligations throughout the wind-down period and support an orderly transition for patients currently receiving therapy (https://www.palforzia.com). However, this voluntary discontinuation is not related to product safety, quality, or efficacy. Initially developed by Aimmune Therapeutics, incorporated as AR101 since 2014, Palforzia received market authorization in the US on January 31, 2020, after having been given a Breakthrough Therapy Designation by the US Food and Drug Administration (FDA) for young patients (aged 4–17 years), the first ever authorized peanut-OIT. EU authorization followed on December 17, 2020, for the same age group, and treatment continuation was allowed also in adults. Aimmune Therapeutics was founded with significant early backing from Food Allergy Research & Education (FARE), a non-profit organization to address the need for approved treatments for food allergies. Nestlé fully acquired Aimmune in 2020 and, on September 4, 2023, divested its AR101 business to Stallergenes Greer. Market authorization was extended to children aged 1–3 by FDA on July 30, 2024, followed by European Medicine Agency (EMA) on January 09, 2025. AR101's efficacy and safety compared with placebo were demonstrated through double-blind, placebo-controlled food challenges (DBPCFCs) conducted in children and adolescents across multiple Phase 3 and extension trials [4, 5]. Despite some limitations, including challenges with adherence and the need for continuous maintenance dosing, AR101 marks a paradigm shift in peanut allergy management by improving safety and enhancing quality of life for both patients and caregivers [4, 5]. This story will now come to an end for economic reasons and we have to reflect whether low implementation into routine care was due to insufficient reimbursement or other reasons. Fortunately, additional treatment options are available or under development for peanut-allergic patients, supplementing traditional peanut-OIT with non-standardized products [6]. Supported by extensive and robust data, peanut-epicutaneous immunotherapy is anticipated to reach the market soon. Early data also highlight other antigen-specific approaches, such as peanut-sublingual immunotherapy, peanut-specific IgG4 antibodies, and peanut-peptide-based subcutaneous vaccines, for example, PVX108 [6]. Furthermore, biologics and small molecules targeting specific immunological pathways are currently under investigation through an antigen-agnostic approach. Omalizumab, an anti-IgE biologic, is presently approved for food allergy in the United States, although it remains unavailable in Europe. With the expansion of therapy we will be able to provide personalized approaches, shaped on the specific patient's need. The discontinuation of AR101 represents more than a commercial setback: it is a cautionary tale about the disconnect between scientific innovation, regulatory approval, and actual patient access to evidence-based therapies. Critical windows during Phase 2 trial design can help shape success for the future therapeutic pipeline (Figure 1). The removal of AR101 from the market is a failure we share. The question is whether we will learn from it. S.A. and L.K. conceived this manuscript, undertook searches, and provided the first draft of this manuscript; then the manuscript was critically revised by all co-authors. We are deeply grateful to all patients, their families, and representatives for providing their data and support, which are essential to advancing food allergy management. The authors have nothing to report. S. Arasi declares that she has participated as an advisory board member, and/or consultant, and/or speaker/chair at scientific meetings for Aimmune, DBV, Ferrero, Mabylon, Novartis, Stallergenes Greer, Thermo Fisher Scientific, and Ulrich outside the submitted work. Research support was provided to her institution by the Italian Minister of Health and Italian Minister of Education. A. Anagnostou reports institutional funding (Aimmune and Novartis), advisory board membership (Genentech, Novartis, Bryn, and ready set food), and consultation/speaker fees (ALK, Adelphi, Aimmune Therapeutics, MJH, FARE, Genentech, EPG Health, Medscape, and ARS). K. Blumchen reports institutional grants by Novartis Pharma GmbH, Aimmune Therapeutics, DBV Technologies, Allergy therapeutics, Nestle, and Hipp GmbH; consulting fees by Novartis Pharma GmbH, HAL, Nestle, Bencard Allergie, Aimmune Therapeutics, ALK, Stallergenes Greer, Celltrion, and DBV Technologies; honoraria by Aimmune Therapeutics, DBV Technologies, Novartis Pharma GmbH, Thermo Fisher Scientific, Viatris Healthcare GmbH, Allergopharma, Bencard Allergie, Sanofi, Engelhard, ALK, Siemens healtheneers, and Danone; meeting/travel support by DBV Technologies, Novartis Pharma GmbH, and Aimmune Therapeutics; and Participation Data Safety Monitoring Board/Advisory Board by Novartis Pharma GmbH. K. Beyer reports funding to her institution for grants from the German research foundation, the German Federal Ministry of Education and Research (BMBF), the German Federal Ministry of Food and Agriculture (BMEL), Aimmune, Danone, DBV, Hipp, Infectopharm, Hycor, Novartis; and having received speaking honoraria from Aimmune, ALK, Danone, Infectopharm, Nestle, Hycor, Thermo Fisher, Kantar Health, Labor 28, Stallergenes, consulting fees from Hipp, Novartis, and advisory board honoraria from Aimmune, ALK, Danone, Viatris, Nestle, Allergy Therapeutics, Novartis, Kantar Health, Primus Consulting, and Stallergenes outside the submitted work. P. Bégin reports grants or contracts from DBV Technologies, Regeneron, Novartis, Sanofi, ALK, and Rapt Therapeutics; honoraria from, DBV Technologies, Novartis, ALK, Viatris, Rapt Therapeutics, and Pfizer; a leadership role in Food Allergy Canada, the Canadian Society of Allergy and Clinical Immunology, and Allergy, Asthma & Clinical Immunology (associate editor); and receipt of drug (omalizumab) from Novartis for research study, all outside the submitted work. Dr. Chinthrajah receives grant support from the Consortium for Food Allergy Research (CoFAR), National Institute of Allergy and Infectious Disease (NIAID), Food Allergy Research & Education (FARE) and is an advisor for Novartis, Intrommune Therapeutics, Phylaxis, Genentech, Latitude, RAPT, Blueprints Therapeutics, and Grow Happy. She owns stock for Intrommune Therapeutics and Grow Happy. M. Ebisawa reports Speaker and Advisory Board honoraria from Viatris, Novartis, Sanofi, and ARS-Pharmaceuticals. T. Eiwegger reports grants or contracts from DBV Technologies, ALK-Abelló, Stallergenes Greer, and Novartis; consulting fees from ALK-Abelló; honoraria from Aimmune Therapeutics, Thermo Fisher Scientific, Nutricia/Danone, ALK-Abelló, Novartis, and MADx; payment for expert testimony from Aimmune Therapeutics; support for attending meetings from Sanofi; participation on a data safety monitoring board or advisory board from ALK-Abelló, Aimmune Therapeutics, Stallergenes Greer, and Nutricia/Danone; leadership for or fiduciary payment from the European Academy of Allergy & Clinical Immunology; and receipt of equipment, materials, drugs, medical writing, gifts, or other services from MADx. A. Fiocchi has received Speaker honoraria and advisory panel consultancy outside the submitted work for Nutricia, Abbott, Danone, Stallergenes, DBV, Novartis. Research support was provided to the institution by the Sanofi, Novartis, Ferrero, DBV, GSK, Astrazeneca, Hipp GmBDH, Humana SpA. IJA reports personal fees from Bayer, Bial, Cipla, Eurodrug, Faes Farma, Gebro, Glenmark, Opella, Menarini, MSD, Roxall, and Sanofi outside the submitted work. A. Muraro reports speaker fees for Aimmune, Nestlé Health Science, Nestlé Purina, DVB Technologies, and Sanofi; and advisory boards for Sanofi, DVB Technologies, Nestlé Health Science, Novartis, and Regeneron. Dr. Sindher reports grants from NIH, Regeneron, DBV Technologies, Aimmune, Novartis, CoFAR, and FARE. She is an Advisory member at Genentech and DBV Technologies. M.H.Shamji reports research grants from Immune Tolerance Network, Medical Research Council, Allergy Therapeutics, LETI Laboratorios, and Rovolo Biotherapeutics, and lecture fees from Allergy Therapeutics and LETI Laboratorios, all outside the submitted work. M.J. Torres reports receipt of grants/research supports from European Commission, SEAIC, ISCIII and receipt of honoraria or consultation fees from Leti Laboratories, Aimmune Therapeutics, and Diater Laboratories. J.E.M. Upton reports grants or contracts from DBV Technologies, Regeneron, Sanofi, ALK-Abelló, the Canadian Institutes of Health Research, the SickKids Food Allergy and Anaphylaxis Program, and Innovation Fund Denmark; honoraria from Pear Healthcare, AstraZeneca, Viatris, and Pfizer; participation on the advisory board for Pfizer, Bausch Health, Pharming, and ALK-Abelló; a leadership role in Food Allergy Canada, the Canadian Society of Allergy and Clinical Immunology, Allergy (editorial board), Annals of Allergy, Asthma & Immunology (editorial board), and Allergy, Asthma & Clinical Immunology (associate editor); and receipt of drug (omalizumab) from Novartis for research study, all outside the submitted work. L. Klimek has received research grants from Allergy Therapeutics/Bencard, Great Britain/Germany; ALK-Abelló, Denmark; Allergopharma, Germany; Aimmune, USA; ASIT Biotech, Belgium; AstraZeneca, Sweden; Bionorica, Germany; Biomay, Austria; Boehringer Ingelheim, Germany, Circassia, USA; Chiesi, Italy; Cytos, Switzerland; Curalogic, Denmark; HAL, Netherlands; Lofarma, Italy; Menarini, Italy; Viatris/Mylan, USA; Novartis, Switzerland; Leti, Spain; ROXALL, Germany; GlaxoSmithKline (GSK), Great Britain; Sanofi, France; Stallergenes, France; Thermo Fisher, USA; and/or has served on the speaker's bureau or was consulting for the above-mentioned pharmaceutical companies. L.K. is the current President of German Society of Allergology AeDA, Vice-President of the European Academy for Allergy and Clinical Immunology (EAACI), Vice-President of the German Academy for Allergy and Environmental Medicine, and Editor-in-Chief of AllergoJournal and AllergoJournal International. All are outside of the submitted work. All other authors have no conflicts of interest within the scope of the submitted work. Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.