Table 3. Summary of advantages and... | American Society of Hematology

Table 3.

Summary of advantages and disadvantages of the different strategies

Variants	Advantages	Disadvantages
Coadministration	Minimal optimization: allows for combination of 2 single CAR constructs Dose can be adjusted for each single CAR product	High manufacturing cost Coordination and regulation around 2 infusions of 2 different products
Cotransduction	Minimal optimization: allows for combination of 2 single CAR constructs	High manufacturing cost Heterogeneity in product composition may result in uneven expansion in vivo
Bicistronic vector	Only 1 vector (lower cost) Homogeneous product Single activation signal	Large vector size can result in lower transduction efficiency Impact of increased CAR density/signaling uncertain
Bivalent CAR	Only 1 vector (lower cost) Homogeneous product Single activation signal	Optimization of construct to ensure efficient targeting of both antigens challenging

Variants	Advantages	Disadvantages
Coadministration	Minimal optimization: allows for combination of 2 single CAR constructs Dose can be adjusted for each single CAR product	High manufacturing cost Coordination and regulation around 2 infusions of 2 different products
Cotransduction	Minimal optimization: allows for combination of 2 single CAR constructs	High manufacturing cost Heterogeneity in product composition may result in uneven expansion in vivo
Bicistronic vector	Only 1 vector (lower cost) Homogeneous product Single activation signal	Large vector size can result in lower transduction efficiency Impact of increased CAR density/signaling uncertain
Bivalent CAR	Only 1 vector (lower cost) Homogeneous product Single activation signal	Optimization of construct to ensure efficient targeting of both antigens challenging

Adapted from Cordoba et al⁴⁹ and Xie et al.⁴⁷