Immune complexes and human neoplasia.

The vast data pertaining to circulating immune complexes (CIC) detection and their possible clinical significance in human neoplasia have been reviewed. The clinical relevance of CIC occurrence in cancer patients' sera provide important non-diagnostic information on staging, evaluation of prognosis, detection of early recurrence, and quantitation of tumor response to treatment. A variable prevalence of CIC in cancer patients is now well established. The several reasons which made no available test entirely satisfactory for clinical use, have been discussed indicating the importance of molecular size and composition heterogeneity of CIC detected in cancer patients. Although the evaluation of CIC by current assays represents the antithesis of pre-diagnostic patients management, there are solid reports to suggest its possible clinical application. Those studies noting the relevance of CIC fluctuation to the evaluation of prognosis, monitoring of therapy and assessment of tumor burden were best attained when an effort to quantitate residual disease was undertaken. In addition, attempts to remove CIC from cancer patients circulation by plasma exchange alone or with extracorporeal immunoadsorption have resulted in a better understanding of a frequently observed immunomodulation. This modality provided a challenging and provocative new approach to cancer therapy which deserved prompt corroboration.