Table 1.

Advantages and disadvantages of common dual CAR strategies.

CAR Strategy	Advantages	Disadvantages
Cocktail/ sequential infusion of two Si-CAR T-cell products	Availability of optimized single CAR construct, vectors, and transduction process Precise dose for each Si-CAR T-cell product	High manufacturing cost due to doubling the cost of producing and quality control. Uneven expansion Optimization of the timing of second infusion
Co-transduction with two Si-CAR vectors	Availability of optimized CAR construct and vectors	Optimization of the transduction process High manufacture cost due to twice the amount of vectors and viruses required Heterogeneity of cell products mixed with Si-CAR T cells and Bi-CAR T cells Uneven expansion of Si-CAR T cells
Bicistronic Bi-CART	Dual co-stimulation Homogeneity of cell products	Large vector size Low transduction efficiency
Bivalent Tandem Bi-CART	Reduced manufacture cost Homogeneity of cell products	Complex construct optimization
Bivalent Loop Bi-CART	Reduced manufacture cost Homogeneity of cell products Higher potency than Tandem	Complex construct optimization

Abbreviations: Bi-CART, bispecific chimeric antigen receptor T cells; Bi-CAR-T, bispecific chimeric antigen receptor T-cell; CAR, chimeric antigen receptor; CAR-T, chimeric antigen receptor T cell(s); Si-CAR, single-targeted chimeric antigen receptor; Si-CART, single-targeted chimeric antigen receptor T cells.