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Leukocyte adherence inhibition (LAI) is an easily carried out m vztro test for tumor reactivity which is based on the pfevention of adherence of leukocytes incubated with antigen to which the donor is immune. In this study a comparison is made with dermal response to tumor antigen. A total of 234 patients were tested, 74 of whom had melanoma, 111 of whom had squamous cell carcinoma of the head and neck, 18 of whom had neuroblastoma and 31 of whom had other tumors. Forty-two persons without tumors acted as controls for the LA1 test. A high degree of correlation was found between LA1 and dermal response. Furthermore, LA1 exhibited marked tumor specificity and showed a ten-fold greater sensitivity than dermal response. LA1 may be used to monitor serial changes in tumor reactivity in cancer patients.Cancer 41:1034-1039, 1978. HE CLINICAL COURSE OF T H E CANCER PA-T tient, in addition to being dependent upon a number of variables such as tumor type, stage and results of conventional therapy, appears to be also dependent upon the immune response of the tumor host. Whereas overall immune response is influenced by the tumor burden and may be indicative of eventual prognosis, specific antitumor responsiveness may be a much more important predictor of the tumor-host relationship. 21~22 In the past general host immune responsiveness has been determined by dermal reactivity to recall or special antigens, by measurement of antitumor antibody levels in the serum, and by leukocyte reactivity to nonspecific mitogens or nontumor antigens. Specific responsiveness to tumor has been measured by dermal reactivity to tumor antigen extract, 2,5,7,12*14*15~20 by lympokine r e l e a~e ' *~*~,~,~~ and by lymphocyte cytotoxicity to tumor cells. Accepted for publication December 21, 1977 been described for detection of specific tumor immunity." The LA1 test avoids most of the practical disadvantages of the previous tests employed. Determination of specific tumor immunity in cancer patients and the sequential changes which occurred in some of them was studied in 234 patients, 74 of whom had melanoma, 11 1 of whom had squamous cell carcinoma of the head and neck, 18 of whom had neuroblastoma and 31 of whom had other tumors. Forty-two persons without tumors acted as controls. The patients were tested for specific tumor antigen response by using the LA1 test and dermal skin testing with tumor extract. Comparison of these two tests was made including correlation of results with concentration of tumor extract used.The LA1 test is an in uitro test which is based on the prevention of adherence of leukocytes to wetable surfaces when incubated with antigen to which the donor is immune. MATERIALS AND METHODS Tumor ExtractsTumor tissues from surgical operations were obtained within four hours of excijon and handled aseptically throughout extraction. A portion of the tumor was submitted for pathologic examination. The tissues were finely minced, washed repeatedly with saline and freeze-dried. The dried tissue was stored at -2OOC until extraction w...