I'm not familiar with Common Lisp, but in Racket, “GC pauses [...] typically run from 50ms to 100ms” [0]. On a 16ms maximum frame budget, that doesn't really work. Am I missing something?
[0]: https://docs.racket-lang.org/portaudio/index.html#%28part._....
EDIT: I'm aware of GOAL at Naughty Dog — Andy Gavin who wrote it described the GC as being a problem in a HN comment. [1]