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It is unknown whether prechemotherapy plasma <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content>(S) levels are associated with the onset of cancer\u2010related cognitive impairment (<jats:styled-content style=\"fixed-case\">CRCI<\/jats:styled-content>). The objective of this study was to evaluate whether an association exists between prechemotherapy plasma <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content>(S) levels and onset of <jats:styled-content style=\"fixed-case\">CRCI<\/jats:styled-content> in patients with breast cancer receiving chemotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Multicenter, prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two specialized cancer centers in Singapore.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Eighty\u2010one patients with early\u2010stage breast cancer (stages I\u2013<jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>) who had no prior exposure to chemotherapy and\/or radiotherapy and were scheduled to receive anthracycline\u2010based or taxane\u2010based chemotherapy treatment with curative intent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and Main Results<\/jats:title><jats:p>Patients completed assessments for self\u2010perceived and objective cognitive function at three time points: prechemotherapy (T1), during chemotherapy (T2), and after chemotherapy (T3). Plasma samples were collected prior to chemotherapy, and <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content>(S) levels were quantified by using ultra\u2013high\u2010performance liquid chromatography\u2013tandem mass spectrometry. Multivariable logistic regression was used to adjust for clinically important factors and to evaluate the association between prechemotherapy plasma <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content>(S) levels and <jats:styled-content style=\"fixed-case\">CRCI<\/jats:styled-content>. Mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> age was 48.9\u00a0\u00b1\u00a09.3\u00a0years, with 27.8% of patients experiencing clinically significant cognitive impairment based on global Functional Assessment of Cancer Therapy\u2013Cognitive Function scores. The mean\u00a0\u00b1\u00a0<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content> prechemotherapy plasma <jats:styled-content style=\"fixed-case\">DHEAS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content> levels were 1.61\u00a0\u00b1\u00a00.91\u00a0\u03bcmol\/L and 19.21\u00a0\u00b1\u00a013.13\u00a0nmol\/L, respectively. Prechemotherapy <jats:styled-content style=\"fixed-case\">DHEAS<\/jats:styled-content> levels were found to be associated with impairment in the self\u2010perceived cognitive domains of verbal fluency (adjusted odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 0.27, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.08\u20130.96) and mental acuity (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.25, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.08\u20130.74). Conversely, <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content> levels were not associated with impairment in any cognitive subdomains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggest that patients with higher prechemotherapy <jats:styled-content style=\"fixed-case\">DHEAS<\/jats:styled-content> levels had lower odds of developing self\u2010perceived cognitive impairment. Future studies are required to further investigate the effect of <jats:styled-content style=\"fixed-case\">DHEA<\/jats:styled-content>(S) on specific cognitive domains and to validate our findings in independent cohorts.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2259","type":"journal-article","created":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T07:39:36Z","timestamp":1553067576000},"page":"553-563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Prechemotherapy Levels of Plasma Dehydroepiandrosterone and Its Sulfated Form as Predictors of Cancer\u2010Related Cognitive Impairment in Patients with Breast Cancer Receiving Chemotherapy"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2997-555X","authenticated-orcid":false,"given":"Yi Long","family":"Toh","sequence":"first","affiliation":[{"name":"Department of Pharmacy Faculty of Science National University of Singapore 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