A genetic test could one day spot breast cancer patients most at risk of relapsing after treatment with a commonly used powerful chemotherapy.
The find could spare patients the side-effects of a drug destined to fail.
US researchers tested tumours for activity from two genes which appeared to cut the effectiveness of a class of cancer drugs.
UK cancer experts said it was another step towards "personalised" cancer treatment.
The fact that a drug may be highly effective in some patients, but not others, cannot be easily explained.
Scientists now believe that the molecular properties of patients and their tumours may be the key to understanding this - and choosing the right type of treatment.
The team from the Dana-Farber Cancer Institute, in Boston, Massachusetts, scanned the genetic code of tumours taken from women who had undergone treatment, looking for differences which could account for differences in outcome, focusing on a single class of drugs called anthracyclines.
They found a small region on a single chromosome, and within it two genes which seemed to be unusually active in drug-resistant tumours.
When checks were made on samples from 85 other women, those with high levels of activity from these two genes were those who did worst when treated with anthracyclines.
They believe that by checking tumours in advance, treatment regimes could be changed to those involving alternative drug types.
'Appropriate treatment'
Dr Eric Winer, director of the Breast Oncology Center at Dana-Farber, said: "While this work remains preliminary, it may ultimately help us use the anthracyclines in a much more thoughtful manner and allow us greater ability to personalise our breast cancer treatments to the tumour and the patient."
UK cancer charities welcomed the research, although they cautioned that it could be some time before the results were confirmed and any test developed.
Meg McArthur, from Breakthrough Breast Cancer, said: "This research is a step towards discovering why some patients benefit more than others from a common form of chemotherapy.
"Research like this is important for identifying the appropriate treatment for individual patients."
Oliver Childs, from Cancer Research UK, said: "Finding ways to predict how patients will respond to chemotherapy is important to help them benefit as much as possible from their cancer treatment.
"It is too early to say whether this research will lead to a predictive test, but work like this inches us a little closer towards an age of personalised cancer treatment."
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