- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT06275737
POP-UP: et enkelt-arm, to-kohortestudie: Trimodal præhab for øvre GI og bugspytkirtelkræft (POP-UP)
Trimodal Peri Operativ præhabilitering for øvre øsogastrisk og bugspytkirtelkræft: Et multicenter, to-kohorte, åbent, enkeltarmet POP-UP GERCOR-studie
Studieoversigt
Status
Betingelser
Intervention / Behandling
Detaljeret beskrivelse
POP-UP-undersøgelsen har til formål at evaluere gennemførligheden og den foreløbige effektivitet af et 8-ugers trimodalt præ/posthabiliteringsprogram (bestående af personlig tilpasset tilpasset fysisk aktivitet [APA], ernæringsvurdering og psykologisk støtte) med fjernovervågning af APA-sessionerne og sygeplejerske koordination hos patienter med lokaliseret (resektabel eller borderline resektabel) PDAC, som behandles med neoadjuverende eller induktionsbehandling (FOLFIRINOX: 5-fluorouracil/folinsyre, oxaliplatin, irinotecan) før operation og med resektabel OGC behandlet med perioperativ kemoterapi (FLOT: 5- fluorouracil/folinsyre, oxaliplatin, docetaxel).
Præhabiliteringsprogrammet vil blive gennemført under neoadjuverende kemoterapi og de 3-5 uger før operationen i i alt 8 uger før operationen. Der vil være i alt tre præhabiliterende hospitalsdage i løbet af præhabiliteringsprogrammet.
Den præoperative præhabilitering vil omfatte:
- En gang om måneden, en præhabiliterende hospitalsdag med vurdering af funktionsevne med validerede tests foretaget af en fysioterapeut eller en APA-professionel (i henhold til centrets ressourcer/funktion), læge- og sygeplejerskevurdering, der evaluerer præstationsstatus, kemoterapitoksicitet og -tolerance, og ernæringsvurdering ( i henhold til funktionen af hvert center vil det blive lavet af disse fagfolk -med universitetsuddannelse i ernæring- eller en diætist). En terapeutisk træningssession om overholdelse af præhabiliteringsprogrammet vil blive gennemført af sygeplejersken (uddannet i terapeutisk uddannelse).
- Ugentligt vil en professionel APA-træner følge det hjemmebaserede APA-program ved hjælp af app (Activiti®). Den vil tage udgangspunkt i den funktionsevnevurdering, der er foretaget i løbet af den præhabiliterende sygehusdag. Træningsprogrammet vil bestå af to gange om ugen autonomi sessioner, superviseret og tilpasset af APA professionel, og en gang om ugen en guidet session med APA professional. Patienten vil have i alt 3 fysiske aktivitetssessioner om ugen.
- En gang om ugen vil den praktiserende sygeplejerske (eller sagsbehandleren, alt efter centrets funktion) evaluere patienten via en videokonference for at vurdere kemoterapiens toksicitet og tolerance og patientens vægtændringer.
Posthabiliteringsprogrammet starter i i alt 8 uger, en uge efter operationsudskrivning. Strukturen er den samme som præhabiliteringsprogrammet bortset fra efterfølgende af kemoterapitoksicitet og tolerance, der vil blive erstattet af følge af kirurgiske komplikationer/konsekvenser.
Der vil være i alt tre posthabiliteringsdage på hospitalet i løbet af posthabiliteringsprogrammet.
Undersøgelsestype
Tilmelding (Anslået)
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
- Navn: Marie-Line GARCIA LARNICOL, MD
- Telefonnummer: +33 (01) 40 29 85 04
- E-mail: marie-line.garcia-larnicol@gercor.com.fr
Undersøgelse Kontakt Backup
- Navn: Eva Ester MOLINA BELTRAN
- E-mail: evaester.molinabeltran@curie.fr
Studiesteder
-
-
-
Dijon, Frankrig
- Ikke rekrutterer endnu
- Centre Hospitalier Universitaire Dijon Bourgogne
-
Kontakt:
- Olivier FACY, MD
-
Grenoble, Frankrig
- Ikke rekrutterer endnu
- Institut Daniel Hollard - Groupe Hospitalier Mutualiste de Grenoble
-
Kontakt:
- Camille HERVE, MD
-
Lille, Frankrig
- Ikke rekrutterer endnu
- Centre Hospitalier Universitaire de Lille
-
Kontakt:
- PIESSEN Guillaume, MD
-
Marseille, Frankrig
- Ikke rekrutterer endnu
- Institut Paoli-Calmettes
-
Kontakt:
- Brice CHANEZ, MD
-
Marseille, Frankrig
- Ikke rekrutterer endnu
- Hospital La Timone
-
Kontakt:
- Laetitia DAHAN, MD
-
Reims, Frankrig
- Ikke rekrutterer endnu
- CHU de Reims
-
Kontakt:
- Olivier BOUCHE, MD
-
Rouen, Frankrig
- Ikke rekrutterer endnu
- CENTRE HOSPITALIER UNIVERSITAIRE ROUEN - CHU Charles Nicolle
-
Kontakt:
- Lilian SCHWARZ, MD
-
Saint-Cloud, Frankrig
- Rekruttering
- INSTITUT CURIE de SAint Cloud
-
Kontakt:
- Cindy NEUZILLET, MD
-
Saint-Herblain, Frankrig
- Ikke rekrutterer endnu
- Institut de Cancerologie de L'Ouest Rene Gauducheau
-
Kontakt:
- Damien VANSTEENE, MD
-
St-Malo, Frankrig
- Ikke rekrutterer endnu
- Groupe hospitalier Rance Emeraude (CHU Saint-Malo)
-
Kontakt:
- Anais BODERE, MD
-
Tours, Frankrig
- Ikke rekrutterer endnu
- Centre Hospitalier Universitaire Tours - Hopital Trousseau
-
Kontakt:
- Thierry LECOMTE, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Underskrevet og dateret patientinformeret samtykkeformular (ICF) og villighed til at overholde alle undersøgelsesprocedurer og tilgængelighed i undersøgelsens varighed,
- Histologisk eller cytologisk lokaliseret PDAC eller OGC valideret af det multidisciplinære team,
- Indikation for præoperativ behandling med triplet kemoterapi i ≥ 4 cyklusser (8 uger), Bemærk: Patient behandlet for PDAC, første cyklus uden oxaliplatin er godkendt.
- Alder > 18 år; Hvis alderen ≥ 75 år: G8-score skal være ≥ 14 og hvis < 14 validering af onkogeriatrisk specialist,
- Eastern Cooperative Oncology Group præstationsstatus (ECOG PS) på 0-1 ved inklusionsbesøg (første præhabiliteringshospitaldag),
- Ingen forudgående behandling for PDAC eller OGC før screeningsbesøg,
- Mindst én målelig eller evaluerbar læsion vurderet ved computeriseret tomografi-scanning eller magnetisk resonansbilleddannelse i henhold til RECIST 1.1 og gennemførligheden af gentagne radiologiske vurderinger på baseline-billeddannelse før start af kemoterapi,
- Tilstrækkelig hæmatologisk funktion og endeorganfunktion, der muliggør den tredobbelte kombinationskemoterapiprotokol,
- Registrering i et nationalt sundhedssystem (PUMa - Protection Universelle Maladie inkluderet).
Ekskluderingskriterier:
- Evidens for metastatisk sygdom ved billeddannelse (valideret i tværfaglig teamevaluering),
- Histologi af andet end adenokarcinom,
- Enhver medicinsk (herunder kardiovaskulær, respiratorisk, psykiatrisk, muskuloskeletal eller neurologisk) tilstand, der kontraindikerer træningspraksis,
- Patienter med medicinsk kontraindikation til operation på grund af almentilstand eller følgesygdomme
- Graviditet eller amning,
- Patient under en retsbeskyttelsesordning (værgemål, kuratorskab, retssikkerhed) eller administrativ afgørelse eller ude af stand til at give sit samtykke,
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Andet
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
|---|---|
|
Andet: Kohorte 1 og kohorte 2
Kohorte 1 - Patienter med PDAC Kohorte 2 - Patienter med OGC |
Kohorte 1 - Præhabiliteringsprogram vil blive implementeret under de sidste cyklusser af neoadjuverende kemoterapi (cyklus 5 - cyklus 6 eller cyklus 6 - cyklus 8) og ugerne forud for operationen (planlagt 3-4 uger efter den sidste kemoterapicyklus) Kohorte 2 - Præhabiliteringsprogram vil blive implementeret under de sidste cyklusser af neoadjuverende kemoterapi (cyklus 2 - cyklus 4) og ugerne forud for operationen (planlagt 3-4 uger efter den sidste kemoterapicyklus) |
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
The feasibility of personalized, 8-week trimodal pre-habilitation program alongside perioperative triplet chemotherapy
Tidsramme: 8 weeks
|
The success of pre-habilitation is defined by the achievement of the following three criteria:
|
8 weeks
|
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Succesrate for APA, ernæringsmæssige og psykologiske interventioner
Tidsramme: 8 uger
|
Evaluerer afslutning og overholdelse af hver intervention separat i henhold til foruddefinerede succes-kriterier.
Måleenhed: Andel af patienter (%) der opnår foruddefinerede succes-kriterier
|
8 uger
|
|
Vurdering af overlevelse (OS)
Tidsramme: op til 12 måneder efter operationen
|
OS defineres som tiden (i måneder) mellem inklusionsdatoen og 12 måneder efter operationen
|
op til 12 måneder efter operationen
|
|
Vurdering af sygdomsfri overlevelse (DFS)
Tidsramme: op til 12 måneder efter operationen
|
DFS defineret som tiden (måneder) mellem inklusionsdatoen og datoen svarende til 12 måneder efter operationen
|
op til 12 måneder efter operationen
|
|
Vurdering af sygeplejerskeindgreb
Tidsramme: 8 uger
|
Sygeplejerskeinterventionen vil blive evalueret ud fra: Måleenhed: Antal alarmer håndteret af sygeplejersker og onkologer, Ugentlig fuldførelsesprocent for fjernopfølgning (%), Planlagte vs. fuldførte præhabiliterings-/posthabiliteringssessioner (%), og Sygehusdage
|
8 uger
|
|
Brug af G-CSF og neutropenivurdering
Tidsramme: 8 uger
|
Hematologisk støtte og neutropeni vil blive evalueret.
Måleenhed: G-CSF recept (ja/nej), rate af grad ≥2 neutropeni (%) |
8 uger
|
|
Vurdering af perioperativ kemoterapirate
Tidsramme: 8 uger
|
Vurdering af gennemførelsen af planlagte perioperative kemoterapicykler hos kvalificerede patienter.
Måleenhed: Antal/andel af patienter med planlagt vs. modtaget antal perioperative kemoterapicykler.
|
8 uger
|
|
Kemoterapidosis modtaget
Tidsramme: 8 uger
|
Relativ dosisintensitet vil blive målt.
Måleenhed: Procentdel af planlagt dosis modtaget (%) |
8 uger
|
|
Health-related quality of life assessment by EORTC QLQ-C30
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
HRQoL will be assessed by using the EORTC QLQ-C30 questionnaire at screening, once per month and at the end of intervention visit.
The EORTC QLQ-C30 is a cancer specific questionnaire assessing 15 HRQOL scales through 30-items; for each dimension, one score is generated according to the recommendations of the EORTC on a 0-100 scale in order that a high score represents a high functional level, a high Global QoL level, and a high symptomatic level.
|
Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
|
Health-related quality of life assessment by EORTC QLQ-PAN26
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
The EORTC QLQ-PAN26 is a module specific to pancreatic cancer, to be used in conjunction to the EORTC QLQ-C30.
It contains 26 items.
As for the EORTC QLQ-C30, one score is generated for each score according to the recommendations of the EORTC on a 0-100 scale in order that a high score represents a high functional level and a high symptomatic level.
|
Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
|
Health-related quality of life assessment by EORTC QLQ-OG25
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
The EORTC QLQ-OG25 is a module specific to esophago-gastric cancer to use in conjunction to the EORTC QLQ-C30.
It contains 25 items.
One score is generated for each score according to the recommendations of the EORTC on a 0-100 scale in order that a high score represents a high functional level and a high symptomatic level
|
Inclusion, week 4, week 8, week +1, week +5, Week +9, follow-up (up to 17 months)
|
|
Chemotherapy tolerance assessment
Tidsramme: 8 weeks
|
The chemotherapy tolerance with the CTCAE V5.0 (Grade ≥ 3) will be evaluated.
Unit of Measure: Number and proportion of patients with Grade ≥3 toxicities (CTCAE v5.0) Toxicities requiring hospitalization, treatment delays, and dose reductions related to toxicity will also be assessed
|
8 weeks
|
|
Postoperative complications assessment
Tidsramme: Surgery and postoperative period (up to 90 days post-surgery)
|
Major postoperative complications will be measured.
Unit of Measure: Number/proportion of patients with Clavien-Dindo Grade ≥3 complications - evaluates serious surgical complications requiring intervention under anesthesia, ICU care, or resulting in death.
|
Surgery and postoperative period (up to 90 days post-surgery)
|
|
Adherence to APA program assessment
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Tracks patient participation in post-habilitation APA sessions and documents reasons for drop-out.
Unit of Measure: Number and proportion of patients completing sessions (%).
Adherence will also be evaluated using patient-reported outcomes collected through the Activiti® application and APA professional assessments, including the number of APA sessions performed and APA dose intensity.
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Pancreatic function assessment
Tidsramme: week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Fecal elastase and pancreatic enzyme use will be assessed.
Unit of Measure: Levels of fecal elastase (µg/g) and pancreatic enzyme consumption (units/day).
|
week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Surgical rate assessment
Tidsramme: Surgery and postoperative period
|
Surgical rate will be assessed.
Unit of Measure: Number/proportion of patients with surgery
|
Surgery and postoperative period
|
|
Nutritional Status Assessment - Body composition
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Evaluating changes in skeletal muscle and fat mass to assess nutritional status during the prehabilitation program.
Outcome Measure: Skeletal muscle and adipose tissue areas.
Unit of Measure: cm² (cross-sectional area at L3 via TAP-CT or bioimpedance)
|
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Nutritional Status Assessment - weight and BMI
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Evaluating changes in body weight and BMI to monitor nutritional status.
Unit of Measure: kg (weight), kg/m² (BMI).
|
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Nutritional Status Assessment - Food intake
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Measuring dietary intake and eating behavior to assess nutritional status.
Unit of Measure: Simple Evaluation of Food Intake (SEFI) visual analog scale.
The score is reported using the SEFI visual analog scale, which ranges from 0 to 10, where higher scores indicate better food intake.
|
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Nutritional Status Assessment - Serum Albumin evaluation
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Evaluating nutritional status through Serum Albumin evaluation. Unit of Measure: g/L. Meaning: Higher albumin levels indicate better nutritional status and overall protein reserves. Interpretation: Good: Higher values (within normal laboratory range) Bad: Lower values (may indicate malnutrition or poor protein intake) |
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Nutritional Status Assessment - C-Reactive Protein (CRP) evaluation
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Evaluating inflammatory status through CRP levels. Unit of Measure: mg/L. CRP is a marker of inflammation. Lower CRP indicates lower inflammatory activity. Interpretation: Good: Lower values (normal or near-normal, minimal inflammation) Bad: Higher values (indicating active inflammation or possible infection) |
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Nutritional Status Assessment - Complete Blood Count (CBC) Parameters evaluation
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
Description: Evaluating general health and nutritional status through CBC parameters (e.g., hemoglobin, hematocrit, leukocytes). Unit of Measure: Standard laboratory units (e.g., g/dL for hemoglobin, cells/µL for leukocytes). Meaning: CBC evaluates general health and nutritional status (e.g., hemoglobin for anemia, leukocytes for immune status). Interpretation: Good: Values within normal reference ranges Bad: Values outside normal ranges (e.g., low hemoglobin = anemia, abnormal leukocytes = possible infection or immune dysfunction) |
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months), end of study (at 4 years)
|
|
Functional Status Assessment - Behavioral changes in physical activity (International Physical Activity Questionnaire [IPAQ-S])
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months)
|
Assessing daily physical activity using IPAQ-S.
It is a 7-item questionnaire in which duration (hours and minutes per day), frequency (times per week), and intensity (walking, moderate and vigorous) of the previous 7 days will be collected.
Sedentary time (self-reported time spent sitting) in the same time period will be recorded (hours/min/day).Unit of Measure: MET-min/week and Minutes/day.
|
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months)
|
|
Functional Status Assessment - 6-minute walk test
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Assessing functional exercise capacity.
Outcome Measure: Walking distance (meters).
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Functional Status Assessment - Handgrip strength
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Assessing upper body muscle strength.
Unit of Measure: Kilograms (kg)
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Functional Status Assessment - Sit-to-stand test (STS)
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Measuring lower limb strength and functional capacity.
Unit of Measure: Repetitions per minute
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Functional Status Assessment - Borg scale
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Measuring subjective exertion during functional tests.
Unit of Measure: Score.
Score on the Borg scale ranges from 6 (no exertion) to 20 (maximal exertion).
Lower scores indicate lighter effort (better functional tolerance), higher scores indicate greater perceived exertion (more strain).
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Functional Status Assessment - Balance
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Measuring balance and stability.
Unit of Measure: Seconds
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Functional Status Assessment - Time Up and Go (≥70 years)
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9
|
Measuring mobility and fall risk in older patients.
Unit of Measure: Seconds
|
Inclusion, week 4, week 8, week +1, week +5, week +9
|
|
Hospital Anxiety and Depression Scale (HADS) assessment
Tidsramme: Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months)
|
The HADS is a 14-item questionnaire assessing anxiety through 7 items and depression with 7-items.
One score is generated per dimension on a 0-21 scale with the sum of the corresponding items.
A score between 0 and 7 represents the absence of anxiety/depression.
More of 9 in HADS-anxiety (A) is considered as a presence of an anxiety disorder which needs the intervention of a psychologist (anxiety) and more of 7 in HADS-depression (D) is considered as a presence of depression disorder which needs the intervention of a psychiatrist (depression).
|
Inclusion, week 4, week 8, week +1, week +5, week +9, follow-up visits (up to 17 months)
|
Andre resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Exploratory outcome measure - Changes in imaging assessment
Tidsramme: Baseline to preoperative assessment
|
Comparing baseline imaging with preoperative imaging to assess changes in body composition and tumor characteristics, stratified by completion of the prehabilitation program.
Unit of Measure: cm² for body composition, mm or cm³ for tumor size
|
Baseline to preoperative assessment
|
|
Exploratory outcome measure - Changes in tumor specimen
Tidsramme: At surgery
|
Evaluating differences between baseline diagnostic biopsy and resected surgical specimen for each patient, stratified by completion of the prehabilitation program.
Unit of Measure: Pathologic features (categorical or qualitative).
|
At surgery
|
Samarbejdspartnere og efterforskere
Efterforskere
- Ledende efterforsker: Cindy Neuzillet, MD, Institut Curie, Saint-Cloud
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Anslået)
Studieafslutning (Anslået)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
- POP-UP G-128
Plan for individuelle deltagerdata (IPD)
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