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BNC105P in Combination With Everolimus/Following Everolimus For Progressive Metastatic Clear Cell Renal Cell Carcinoma

7 de julio de 2022 actualizado por: Hoosier Cancer Research Network

Phase I/II Study of BNC105P in Combination With Everolimus or Following Everolimus For Progressive Metastatic Clear Cell Renal Cell Carcinoma Following Prior Tyrosine Kinase Inhibitors

The purpose of this study is to determine whether BNC105P in combination with/following everolimus is effective in the treatment of progressive metastatic clear cell renal cell carcinoma following prior tyrosine kinase inhibitors.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Descripción detallada

OUTLINE: This is a multi-center study.

Phase I: Patients will be accrued in the classic 3 patients per dose per cohort design, 21-day cycle

  • Dose Level 1 Everolimus 10 mg BNC105P 4.2 mg/m2
  • Dose Level 2 Everolimus 10 mg BNC105P 8.4 mg/m2
  • Dose Level 3 Everolimus 10 mg BNC105P 12.6 mg/m2
  • Dose Level 4 Everolimus 10 mg BNC105P 16 mg/m2

Phase II: Patients will be randomized 1:1 to Arm A or Arm B

Combination Arm A: Everolimus 10 mg + BNC105P MTD (from Phase 1 study) 21 day cycle

Sequential Arm B: Everolimus 10 mg 21 day cycle

  • Patients to receive BNC105P monotherapy at 16 mg/m2 following progression or intolerable toxicity on everolimus therapy.

Karnofsky Performance Score (KPS) ≥70 within 7 days prior to registration for protocol therapy.

Life Expectancy: Not specified

Hematopoietic:

  • White blood cell count (WBC) > 3.5 K/mm3
  • Hemoglobin (Hgb) > 8.5 g/dL
  • Platelets > 100 K/mm3
  • Absolute neutrophil count (ANC) > 1.5 K/mm3

Hepatic:

  • Total Bilirubin < 1.25 x ULN
  • Aminotransferase (AST and ALT) < 2.5 x ULN

Renal:

  • Serum Creatinine < 2.5 x ULN (upper limit normal)

Cardiovascular:

  • No significant cardiovascular events within 6 months (CVA, CAD, peripheral arterial obstruction, arrhythmias, cardiac dysfunction) of registration for protocol therapy
  • No history of clinical CHF or LVEF <50% by Echo (or MUGA) within 30 days prior to registration for protocol therapy.

Tipo de estudio

Intervencionista

Inscripción (Actual)

154

Fase

  • Fase 2
  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Australia
    • New South Wales
      • Camperdown, New South Wales, Australia, 2050
        • Royal Prince Alfred Hospital: Sydney Cancer Centre
      • Randwick, New South Wales, Australia, 2031
        • Prince of Wales Hospital
      • Wahroonga, New South Wales, Australia, 2076
        • Sydney Adventist Hospital Ltd.
    • Queensland
      • Greenslopes, Queensland, Australia, 4120
        • Gallipoli Medical Research Foundation: Greenslopes Private Hospital
      • Herston, Queensland, Australia, 4029
        • Royal Brisbane & Women's Hospital
      • Woolloongabba, Queensland, Australia, 4201
        • Princess Alexandra Hospital
    • South Australia
      • Adelaide, South Australia, Australia, 5000
        • Royal Adelaide Hospital
      • Kurralta Park, South Australia, Australia, 5037
        • Ashford Cancer Centre
    • Tasmania
      • Launceston, Tasmania, Australia, 7250
        • Gallipoli Medical Research Foundation: Launceston General Hospital
    • Victoria
      • Frankston, Victoria, Australia, 3199
        • Peninsula Oncology Centre
      • Heidelberg, Victoria, Australia, 3084
        • Austin Hospital
      • Melbourne, Victoria, Australia, 3004
        • Alfred Hospital
    • Western Australia
      • Perth, Western Australia, Australia, 6000
        • Royal Perth Hospital
  • Estados Unidos
    • Alabama
      • Muscle Shoals, Alabama, Estados Unidos, 35661
        • Northwest Alabama Cancer Center
    • Arkansas
      • Hot Springs, Arkansas, Estados Unidos, 71913
        • Genesis Cancer Center
    • California
      • Burbank, California, Estados Unidos, 91505
        • Providence Health System: Roy and Patricia Disney Family Cancer Center
      • Corona, California, Estados Unidos, 92879
        • Compassionate Cancer Care Medical Group, Inc.
      • Corona, California, Estados Unidos, 92879
        • Compassionate Cancer Care Medical Group
      • Duarte, California, Estados Unidos, 91010
        • City of Hope
      • Fountain Valley, California, Estados Unidos, 92708
        • Robert A. Moss, M.D., FACP, Inc.
      • Fresno, California, Estados Unidos, 93720
        • California Cancer Associates for Research and Excellence
      • Greenbrae, California, Estados Unidos, 94904
        • Marin Specialty Care
      • Los Angeles, California, Estados Unidos, 90017
        • Good Samaritan Hospital
      • Los Angeles, California, Estados Unidos, 90095
        • UCLA Med - Hematology & Oncology
      • Riverside, California, Estados Unidos, 92501
        • Compassionate Cancer Care Medical Group
      • Whittier, California, Estados Unidos, 90603
        • American Institute of Research
    • Colorado
      • Denver, Colorado, Estados Unidos, 80210
        • Centura Health Research Center
      • Golden, Colorado, Estados Unidos, 80401
        • Western Oncology & Hematology
    • Florida
      • Brooksville, Florida, Estados Unidos, 34613
        • Cancer Care Centers of Florida: Brooksville
      • Fort Lauderdale, Florida, Estados Unidos, 33308
        • Broward Oncology Associates
      • Gainesville, Florida, Estados Unidos, 32610
        • University of Florida, Shands Cancer Center
      • Jacksonville, Florida, Estados Unidos, 32256
        • Cancer Specialists of North Florida
      • Miami, Florida, Estados Unidos, 33136
        • Advanced Pharma Cr, Llc
      • New Port Richey, Florida, Estados Unidos, 34652
        • Cancer Care Centers of Florida
      • Ocala, Florida, Estados Unidos, 34471
        • Ocala Cancer Institute
      • Rockledge, Florida, Estados Unidos, 32955
        • Cancer Care Centers of Brevard
    • Georgia
      • Athens, Georgia, Estados Unidos, 30607
        • Northeast Georgia Cancer Care, LLC
      • Dublin, Georgia, Estados Unidos, 31021
        • Dublin Hematology & Oncology Care
    • Idaho
      • Post Falls, Idaho, Estados Unidos, 83854
        • Kootenai Cancer Center
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60611
        • Northwestern University, Robert H. Lurie Comprehensive Cancer Center
      • Galesburg, Illinois, Estados Unidos, 61401
        • Medical & Surgical Specialists, LLC
      • Skokie, Illinois, Estados Unidos, 60076
        • Edward H. Kaplan, M.D., & Associates
    • Indiana
      • Evansville, Indiana, Estados Unidos, 47713
        • Deaconess Clinic
      • Fort Wayne, Indiana, Estados Unidos, 46815
        • Fort Wayne Oncology & Hematology, Inc
      • Goshen, Indiana, Estados Unidos, 46527
        • IU Health Goshen
      • Indianapolis, Indiana, Estados Unidos, 46202
        • Indiana University Melvin and Bren Simon Cancer Center
      • Indianapolis, Indiana, Estados Unidos, 46219
        • IU Health Central Indiana Cancer Centers
      • Indianapolis, Indiana, Estados Unidos, 46256
        • Community Regional Cancer Center
      • Lafayette, Indiana, Estados Unidos, 47905
        • Horizon Oncology Research
      • Muncie, Indiana, Estados Unidos, 47303
        • IU Health at Ball Memorial Hospital Cancer Center
      • Munster, Indiana, Estados Unidos, 46321
        • Monroe Medical Associates
      • Newburgh, Indiana, Estados Unidos, 47630
        • Oncology Hematology Associates of SW Indiana
      • South Bend, Indiana, Estados Unidos, 46601
        • Northern Indiana Cancer Research Consortium
    • Iowa
      • Sioux City, Iowa, Estados Unidos, 51101
        • Siouxland Hematology Oncology Associates, LLP, Nylen Cancer Center
    • Kansas
      • Wichita, Kansas, Estados Unidos, 67214
        • Cancer Center of Kansas
    • Kentucky
      • Hazard, Kentucky, Estados Unidos, 41701
        • Kentucky Cancer Clinic
      • Paducah, Kentucky, Estados Unidos, 42001
        • Purchase Cancer Group
    • Louisiana
      • Baton Rouge, Louisiana, Estados Unidos, 70809
        • Medical Oncology LLC
      • Metairie, Louisiana, Estados Unidos, 70006
        • Metairie Oncologists
    • Massachusetts
      • Boston, Massachusetts, Estados Unidos, 02111
        • Tufts Medical Center
    • Michigan
      • Ann Arbor, Michigan, Estados Unidos, 48106
        • St. Joseph Mercy Hospital
      • Grand Rapids, Michigan, Estados Unidos, 49546
        • Cancer and Hematology Centers of Western Michigan
      • Wyoming, Michigan, Estados Unidos, 49519
        • Metro Health Cancer Care
    • Minnesota
      • Rochester, Minnesota, Estados Unidos, 55905
        • Mayo Clinic
    • Montana
      • Bozeman, Montana, Estados Unidos, 59715
        • Bozeman Deaconness Cancer Center
      • Great Falls, Montana, Estados Unidos, 59405
        • Sletten Cancer Specialists
    • Nebraska
      • Omaha, Nebraska, Estados Unidos, 68114
        • Methodist Cancer Center
    • New Hampshire
      • Manchester, New Hampshire, Estados Unidos, 03102
        • Dartmouth-Hitchcock Medical Center
    • New Jersey
      • Elizabeth, New Jersey, Estados Unidos, 07202
        • Trinitas Regional Medical Center
      • Somerville, New Jersey, Estados Unidos, 08876
        • Somerset Hematology Oncology Associates
    • New Mexico
      • Albuquerque, New Mexico, Estados Unidos, 87110
        • Presbyterian Medical Group
      • Albuquerque, New Mexico, Estados Unidos, 87131
        • University of New Mexico Cancer Center: Albuquerque
    • New York
      • Albany, New York, Estados Unidos, 12208
        • New York Oncology Hematology, PC
      • Buffalo, New York, Estados Unidos, 14263
        • Roswell Park Cancer Institute
      • Lake Success, New York, Estados Unidos, 11042
        • NYU Langone Arena Oncology
      • New York, New York, Estados Unidos, 10029
        • Tisch Cancer Institute at Mount Sinai Medical Center
      • Nyack, New York, Estados Unidos, 10960
        • Hematology Oncology Associates of Rockland
    • North Carolina
      • Pinehurst, North Carolina, Estados Unidos, 28374
        • First Health of the Carolinas
    • Ohio
      • Middletown, Ohio, Estados Unidos, 45042
        • Signal Point Clinical Research Center
      • Wooster, Ohio, Estados Unidos, 44691
        • Lawrence M. Stallings, M.D.
    • Oklahoma
      • Oklahoma City, Oklahoma, Estados Unidos, 73120
        • Mercy Physicians Of Oklahoma
    • Oregon
      • Springfield, Oregon, Estados Unidos, 97477
        • Willamette Valley Cancer Institute
    • Pennsylvania
      • Danville, Pennsylvania, Estados Unidos, 17822
        • Geisinger Medical Center
      • Gettysburg, Pennsylvania, Estados Unidos, 17235
        • Gettysburg Cancer Center
      • Pittsburgh, Pennsylvania, Estados Unidos, 15212
        • Allegheny Cancer Center
      • State College, Pennsylvania, Estados Unidos, 16803
        • Mount Nittany Medical Center
      • West Reading, Pennsylvania, Estados Unidos, 19611
        • Berks Hematology Oncology Associates
    • Rhode Island
      • Cranston, Rhode Island, Estados Unidos, 02920
        • Hematology and Oncology Associates of Rhode Island
    • South Carolina
      • Charleston, South Carolina, Estados Unidos, 29425
        • MUSC Hollings Cancer Center
      • Hilton Head Island, South Carolina, Estados Unidos, 29926
        • South Carolina Cancer Specialists
    • Tennessee
      • Germantown, Tennessee, Estados Unidos, 38138
        • The Jones Clinic, PC
    • Texas
      • Austin, Texas, Estados Unidos, 78758
        • Texas Oncology: Austin North
      • Bedford, Texas, Estados Unidos, 76022
        • Texas Oncology: Bedford
      • Dallas, Texas, Estados Unidos, 75246
        • Texas Oncology, PA
      • Fort Worth, Texas, Estados Unidos, 76104
        • Texas Oncology: Fort Worth
      • Houston, Texas, Estados Unidos, 77030
        • Methodist Hospital Research Institute
      • Houston, Texas, Estados Unidos, 77024
        • Texas Oncology: Houston Memorial City
      • Houston, Texas, Estados Unidos, 77055
        • Houston Cancer Center
      • Lubbock, Texas, Estados Unidos, 79410
        • Joe Arrington Cancer Research and Treatment Center
      • San Antonio, Texas, Estados Unidos, 78229
        • CTRC at the UT Health Science Center at San Antonio
    • Virginia
      • Lynchburg, Virginia, Estados Unidos, 24501
        • Lynchburg Hematology Oncology Clinic, Inc.
    • Washington
      • Bremerton, Washington, Estados Unidos, 98310
        • Harrison HealthPartners Bremerton Hematology & Oncology
      • Kirkland, Washington, Estados Unidos, 98034
        • Cascade Cancer Center
      • Seattle, Washington, Estados Unidos, 98109
        • University of Washington, Seattle Cancer Care Alliance
      • Seattle, Washington, Estados Unidos, 98109
        • Group Health Medical Centers
      • Spokane, Washington, Estados Unidos, 99204
        • Rockwood Clinic
    • Wisconsin
      • Milwaukee, Wisconsin, Estados Unidos, 53226
        • University of Wisconsin, Clinical Cancer Center
  • Singapur
      • Singapore, Singapur, 169610
        • National Cancer Centre Singapore

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Histological or cytological proof of component (any percent) of clear cell RCC (renal cell carcinoma).
  • Metastatic or locally advanced unresectable RCC. NOTE: Prior nephrectomy is not mandatory.
  • Progressive disease after 1-2 prior VEGF-directed tyrosine kinase inhibitors (TKIs).
  • Measurable disease according to RECIST and obtained by imaging within 30 days prior to registration for protocol therapy.
  • Written informed consent and HIPAA authorization for release of personal health information.
  • Age > 18 years at the time of consent.
  • Females of childbearing potential and males must be willing to use an effective method of contraception (hormonal or barrier method of birth control; abstinence) from the time consent is signed until 4 weeks after treatment discontinuation.
  • Females of childbearing potential must have a negative pregnancy test within 7 days prior to registration for protocol therapy.

Exclusion Criteria:

  • No active brain metastases. Patients with neurological symptoms must undergo a head CT scan or brain MRI to exclude brain metastasis within 30 days prior to registration on protocol therapy. NOTE: A patient with prior brain metastasis are eligible if they have completed their radiation treatment for brain metastasis ≥30 days prior to registration for protocol therapy, are off steroids, and are asymptomatic.
  • No other currently active malignancy.
  • No treatment with any investigational agent within 14 days prior to registration for protocol therapy. NOTE: If treated with investigational agent within 14 days prior to registration, AE must be resolved back to baseline.
  • Prior cancer treatment must be completed at least 14 days prior to registration for protocol therapy and the patient must have recovered from the acute toxic effects of the regimen. With the exception of Bevacizumab treatment, which must be completed 30 days prior to registration for protocol therapy.
  • Prior radiation therapy to < 25% of the bone marrow [see bone marrow radiation chart in the study procedure manual (SPM)] allowed if completed within 30 days prior to registration for protocol therapy.
  • Corrected QT interval (QTc) ≤ 450 msec at least 7 days prior to registration for protocol therapy.
  • No clinically significant infections as judged by the treating investigator.
  • No liver disease such as cirrhosis, chronic active hepatitis or chronic persistent hepatitis.
  • No collecting duct, medullary or sarcomatoid histology.
  • No prior treatment with temsirolimus or everolimus in the phase II component of the study. NOTE: Prior treatment with these agents is permitted in the phase I component of the study.
  • No use of full dose, therapeutic anti-coagulation with warfarin or related anti-coagulants or unfractionated or low molecular weight heparins.
  • No uncontrolled hypertension (BP >150/100mmHg despite full doses of 1 anti-hypertensive medication).
  • No thrombotic event within 6 months (deep vein thrombosis, pulmonary embolism) of registration for protocol therapy.
  • No grade 2 or greater peripheral neuropathy.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Comparador activo: Combination Arm A: Everolimus + BNC105P
Combination Arm A: Everolimus 10 mg, BNC105P MTD (from Phase 1 study) 21 day cycle
Droga: Everolimus
Everolimus 10 mg. Taken orally, every evening, 1 hr before or 2 hrs after meals
Droga: BNC105P
BNC105P, up to 16 mg/m^2
Comparador activo: Sequential Arm B:Everolimus followed by BNC105P Monotherapy

Sequential Arm B: Everolimus 10 mg, 21 day cycle

Patients to receive BNC105P monotherapy at 16 mg/m2 following progression or intolerable toxicity on everolimus therapy.
Droga: Everolimus
Everolimus 10 mg. Taken orally, every evening, 1 hr before or 2 hrs after meals
Droga: BNC105P
BNC105P, up to 16 mg/m^2

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Phase I: Maximum Tolerated Dose of BNC105P in Combination With Everolimus.
Periodo de tiempo: Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Phase I
Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Phase I: Toxicities of BNC105P in Combination With Everolimus.
Periodo de tiempo: Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Determine the toxicities of BNC105P in combination with everolimus. Drug-related treatment emergent adverse events by CTCAE grade 2 or greater are reported
Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Phase II: 6-month Progression Free Survival (PFS) With the Addition of BNC105P to Everolimus.
Periodo de tiempo: 6 months
Improvement in 6-month PFS with the addition of BNC105P to everolimus. Progression is defined using RECIST criteria as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions
6 months

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Phase I: Response Rate of BNC105P in Combination With Everolimus.
Periodo de tiempo: Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Number of objective responses per RECIST criteria. Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started.
Until disease progression or unacceptable toxicity, up to 24 cycles or 24 months
Geometric Mean Half-life of BNC105 and BNC105P in Combination With Everolimus.
Periodo de tiempo: 12 months
Determine the PK Profile for BN105P in combination with everolimus by calculating the geometric mean half-life of BNC105P
12 months
Phase II: Response Rate With Combination Therapy Compared to Everolimus Alone
Periodo de tiempo: 12 months
Objective response is defined as a confirmed CR or PR per RECIST criteria. Complete Response (CR): Disappearance of all target lesions. Partial Response (PR): At least a 30% decrease in the sum of the LD of target lesions, taking as reference the baseline sum LD. Progressive Disease (PD): At least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions. Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started.
12 months
Phase II: Progression Free Survival (PFS) With BNC105P Alone in Patients After Progressing on Everolimus.
Periodo de tiempo: 12 months
Median time to progression for arm P participants who crossed over to BNC105P monotherapy after progression. Progression is defined per RECIST criteria as at least a 20% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions
12 months
Phase II: Adverse Events of Everolimus and BNC105P When Administered as a Combination or Sequential Regimen.
Periodo de tiempo: 12 months
Determine adverse events of everolimus and BNC105P when administered as a combination or sequential regimen. Total number of serious and non-serious adverse events for Arm A and Arm B are summarized. Complete adverse event information is supplied in the Adverse Events reporting section.
12 months
Phase II: Overall Survival
Periodo de tiempo: 60 months
Determine overall survival probability, up to a maximum of 5 years from registration for protocol therapy.
60 months
Exploratory Objective: Correlation of PFS With Biomarkers
Periodo de tiempo: 6 months
Exploratory analysis of serum biomarkers were undertaken to generate a potential signature for response. The correlation with 6 month progression free survival P value for four plasma biomarkers is reported.
6 months

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Hoosier Cancer Research Network

Colaboradores

Bionomics Limited

Investigadores

  • Silla de estudio: Thomas Hutson, D.O., Hoosier Cancer Research Network

Publicaciones y enlaces útiles

La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.

Publicaciones Generales

Enlaces Útiles

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de enero de 2010

Finalización primaria (Actual)

1 de diciembre de 2016

Finalización del estudio (Actual)

1 de diciembre de 2016

Fechas de registro del estudio

Enviado por primera vez

15 de diciembre de 2009

Primero enviado que cumplió con los criterios de control de calidad

15 de diciembre de 2009

Publicado por primera vez (Estimar)

17 de diciembre de 2009

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

11 de julio de 2022

Última actualización enviada que cumplió con los criterios de control de calidad

7 de julio de 2022

Última verificación

1 de abril de 2017

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • HOG GU09-145

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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