Physical and lifestyle measures at baseline by age group.

Physical and lifestyle measures at baseline by age group.</p

Recruitment map of ASPREE Biobank participants.

Legend: Map of Australia with rectangle of enlarged south-eastern area showing the major ASPREE Biobank recruitment sites (named) and include the number of Biobank participants recruited from each site. Processing laboratories are indicated by the dotted oval symbols, as are the regions covered by the mobile biobuses indicated by shaded oval areas. The percentages of ASPREE participants recruited to Biobank in each location, relative to the total number of ASPREE participants in each site (listed alphabetically), were Adelaide, SA (61%), Ballarat, VIC (75%), Bendigo, VIC (79%), Burnie, TAS (42%), Canberra, ACT/Southern NSW (66%), Geelong, VIC (73%), Hobart, TAS (78%), Launceston, TAS (46%), Melbourne, VIC (78%), Mildura, VIC (75%), Traralgon, VIC (77%), Warrnambool VIC/Mt Gambier, SA (83%), Wodonga/Albury, VIC/NSW (72%), Wollongong, NSW (76%). A regional site established in Shepparton, VIC closed after collecting 15 samples.</p

Timing of sample transport, processing & storage.

Bar graphs show elapsed time for different stages of sample preparation, categorised into 30 min or 60 min blocks. (A) Sample transport time defined as the elapsed time from sample collection to sample arrival at the processing laboratory (n = 12,219). (B) Sample processing time defined as the elapsed time from sample arrival at the laboratory to storage in a freezer (n = 12,218). (C) Total time from collection to storage in a freezer (n = 12,218). (DOCX)</p

Clinical endpoints in ASPREE Biobank participants during ASPREE (2010–2017) and ASPREE+ASPREE-XT (2010–2020).

Clinical endpoints in ASPREE Biobank participants during ASPREE (2010–2017) and ASPREE+ASPREE-XT (2010–2020).</p

Clinical measures at baseline by age group.

ASPirin in Reducing Events in the Elderly (ASPREE), a placebo-controlled prevention trial of low dose aspirin, provided the opportunity to establish a biospecimen biobank from initially healthy persons aged 70+ years for future research. The ASPREE Healthy Ageing Biobank (ASPREE Biobank) collected, processed and stored blood and urine samples at -80degC or under nitrogen vapour at two timepoints, three years apart, from a willing subset of Australian ASPREE participants. Written informed consent included separate opt-in questions for biomarker and genetic testing. Fractionated blood and urine were aliquoted into multiple low-volume, barcoded cryotubes for frozen storage within 4 hours of collection. Specially designed and outfitted mobile laboratories provided opportunities for participation by people in regional and rural areas. Detailed, high quality demographic, physiological and clinical data were collected annually through the ASPREE trial. 12,219 participants contributed blood/urine at the first timepoint, 10,617 of these older adults provided 3-year follow-up samples, and an additional 1,712 provided saliva for DNA. The mean participant age was 74 years, 54% were female and 46% lived outside major cities. Despite geographical and logistical challenges, nearly 100% of blood/urine specimens were processed and frozen within 4 hours of collection into >1.4 million aliquots. After a median of 4.7 years, major clinical events among ASPREE Biobank participants included 332 with dementia, 613 with cardiovascular disease events, 1259 with cancer, 357 with major bleeds and 615 had died. The ASPREE Biobank houses and curates a large number of biospecimens collected prior to the clinical manifestations of major disease, and 3-year follow-up samples, all linked to high quality, extensive phenotypic information. This provides the opportunity to identify or validate diagnostic, prognostic and predictive biomarkers, and potentially study biological effectors, of ageing-related diseases or maintenance of older-age good health.</div

The survival outcome of patients with metastatic colorectal cancer based on the site of metastases and the impact of molecular markers and site of primary cancer on metastatic pattern

<p><b>Background:</b> Pattern of spread in patients with metastatic colorectal cancer (mCRC) is variable and may reflect different biology in subsets of patients. This is a retrospective study to explore the outcome of patients with mCRC based on their site of metastasis at diagnosis and to explore the association between tumor characteristics [KRAS/RAS, BRAF, mismatch repair (MMR) status, site of primary] and the site of metastasis.</p> <p><b>Methods:</b> Patients from two Australian databases were divided into six groups based on site of metastasis at time of diagnosis of metastatic disease; lung-only, liver-only, lymph node-only or any patients with brain, bone or peritoneal metastases. Primary endpoint was overall survival (OS) of each cohort compared with the rest of the population. A Mantel–Haenszel chi-squared test used to explore the association between site of metastasis and selected tumor characteristics.</p> <p><b>Results:</b> Five thousand nine hundred and sixty-seven patients were included. In a univariate analysis, median OS was significantly higher when metastases were limited to lung or liver and shorter for those with brain, bone or peritoneal metastases (<i>p</i> < .001) in both datasets. BRAF mutation was strongly associated with peritoneal metastases (relative risk = 1.8, <i>p</i> < .001) with lower incidence of lung (RR = 0.3, <i>p</i> = .004) and liver (RR = 0.7, <i>p</i> = .005) limited metastases. Lung-only metastases were more frequent with KRAS/RAS mutation (RR = 1.4, <i>p</i> = .007). Left colon tumors were associated with bone (RR = 1.6, <i>p</i> < .001) and lung-only metastases (RR = 2.3, <i>p</i> = .001) while peritoneal spread was less frequent compared with right colon tumors (RR = 0.6, <i>p</i> < .001). Rectal cancer was associated with brain, bone and lung metastases (RR = 1.7; <i>p</i> = .002, 1.7; <i>p</i> < .001, 2.0; <i>p</i> < .001). Liver-only metastases were less frequent in deficient MMR tumors (RR = 0.7, <i>p</i> = .01).</p> <p><b>Conclusion:</b> Survival duration with mCRC is related to the site of metastases with lung limited disease showing a more favorable survival outcome compared to other single metastatic site disease. The BRAF mutation and primary rectal cancer were associated with poor prognostic metastatic sites.</p

Sample types and numbers stored at baseline and at year 3.

Sample types and numbers stored at baseline and at year 3.</p

Mobile laboratory used to access regional and rural/remote participants to collect and process biospecimens.

Legend: Vehicle outfitted with laboratory grade benches, refrigerated centrifuge, refrigerator, disposable equipment in secure cupboards and drawers, air conditioning, a bed readily converted to an additional bench, a chair for participants, electric step for easy access, a -80 degC portable cryoshuttle and/or LN2 resin insert cryoshipper, an external powerpoint and an external generator to provide power when not connected to main power.</p

Demographics of ASPREE Biobank participants.

ASPirin in Reducing Events in the Elderly (ASPREE), a placebo-controlled prevention trial of low dose aspirin, provided the opportunity to establish a biospecimen biobank from initially healthy persons aged 70+ years for future research. The ASPREE Healthy Ageing Biobank (ASPREE Biobank) collected, processed and stored blood and urine samples at -80degC or under nitrogen vapour at two timepoints, three years apart, from a willing subset of Australian ASPREE participants. Written informed consent included separate opt-in questions for biomarker and genetic testing. Fractionated blood and urine were aliquoted into multiple low-volume, barcoded cryotubes for frozen storage within 4 hours of collection. Specially designed and outfitted mobile laboratories provided opportunities for participation by people in regional and rural areas. Detailed, high quality demographic, physiological and clinical data were collected annually through the ASPREE trial. 12,219 participants contributed blood/urine at the first timepoint, 10,617 of these older adults provided 3-year follow-up samples, and an additional 1,712 provided saliva for DNA. The mean participant age was 74 years, 54% were female and 46% lived outside major cities. Despite geographical and logistical challenges, nearly 100% of blood/urine specimens were processed and frozen within 4 hours of collection into >1.4 million aliquots. After a median of 4.7 years, major clinical events among ASPREE Biobank participants included 332 with dementia, 613 with cardiovascular disease events, 1259 with cancer, 357 with major bleeds and 615 had died. The ASPREE Biobank houses and curates a large number of biospecimens collected prior to the clinical manifestations of major disease, and 3-year follow-up samples, all linked to high quality, extensive phenotypic information. This provides the opportunity to identify or validate diagnostic, prognostic and predictive biomarkers, and potentially study biological effectors, of ageing-related diseases or maintenance of older-age good health.</div

Biobank participant questionnaire data.

Table reports the questions (abbreviated from actual) asked of participants at the time of biospecimen collections and the numbers (and percentage of total) of participants who recorded each answer. The options were “yes” or “no” or “unsure” with the latter numbers including those questions not answered. The differences in the questions at year 3 compared with baseline collections were mainly related to use of open-label aspirin and the ASPREE clinical trial medication. (DOCX)</p