Phillip Koo: Hi, I'm Philip Koo. And welcome back to UroToday's exclusive coverage of the 13th International Uro Oncology Congress here in South Paulo, Brazil. We are very honored to have with us, Dr. Fernando Maluf, who really needs no introduction. He's been such a pioneer with regards to cancer in GU malignancies in Latin America, especially in Brazil and very fortunate to have with him to talk about a variety of issues. So, first off, welcome.

Fernando Maluf: Philip, thank you very much. It's a great pleasure to see you again. We met many, many years ago and we keep seeing each other and I'm glad that you have been coming to Brazil and enjoy this meeting, which is fantastic.

Phillip Koo: Thank you so much. I agree. It's so nice to be able to reconnect with people now that we're sort of hopefully past the issues with COVID. So this meeting, it's the 13th one, first off, congratulations. I've heard so many wonderful things and it's great for us to be here to really increase the reach of this. Can you tell us a little bit more about how this all started and how you see this evolving in the future?

Fernando Maluf: For me, I'm very proud to say that this meeting started initially as a small meeting with no more than 200 people. And not just myself, but our team, put a lot of energy with the Brazilian Urology Society, other societies, the hostels that work in order to expand this meeting regarding trying to make it more popular and more visible to the Brazilian community. Not only the urology and the oncology community, but also the radiation oncologist, the pathologists, the radiologists, and also the other multidisciplinary areas.

So this meeting really grew a lot. Now we have every year, more than 5,000 people in the audience. It turns out to be one of the biggest geo meetings in the world, which for us is now is a reason really to be happy and proud. And also we expanded to the Latin American colleagues and also colleagues all over the world. So now this is a really international meeting.

Aside from the preliminary session we have around 10 parallel courses, which can coverage very important issues that we don't have too much time to cover in deep in the preliminary session. Also, we have a lot of case discussions and meetings with doctors from all over the country to discuss cases in private sessions as well. And as I told you in the expansion project, we are now having a specific part of the meeting for abstracts as we do have for other international meetings.

So it really became a very interesting, productive meeting. It's every year, the duration before was three days, now it's four days. We may think about maybe have a half a day for next year, we are thinking about that. And this year we have 14 international leaders in urology, radiation oncology and medical oncology that came to Brazil to participate in the lectures, the case clinical discussions, which is really, really great. And it's really raising the bar.

Phillip Koo: I absolutely agree. I love the fact that it's so multidisciplinary. When I went through the agenda and just seeing all the specialties involved and even sessions on nutrition and other areas that are so important to oncology and then getting that global perspective, I think was wonderful.

So one of the positive impacts that we've seen through this type of meeting is Latin America's increasing involvement in clinical trials and research, which is wonderful. And we actually interviewed Dr. Tomba earlier, and he talked about how LACOG was such an important part. Can you talk to us about the future of research from the Brazil perspective and the Latin American perspective?

Fernando Maluf: Well, I think this is a really important issue for us. We know that the region has a lot of difficulties and limitations regarding patient care and healthcare projects. One of the things that we made as a group was to create and recently publish a very nice consensus from the screening to diagnosis, to the therapeutic part of prostate cancer in every phase of the disease for developing countries. So for places where you do not have all the tools available.

I'm very fortunate to be part of the Sungalis consensus that has been led brilliantly by Sioki and Aridos. But in that consensus, we vote for the ideal things that unfortunately are not accessible for most of the parts in the world. So we create a very nice consensus that we published on 2020 on JGO, The Journal of Global Oncology. It was eight publications to provide doctors what to do when you don't have that drug available, when you don't have the radiation therapy available at that point, when you don't have skilled surgeons to do a radical prostatectomy, for example. So this was one of the things that we have been working a lot is to try to develop consensus to help healthcare providers how to manage people the best way we can regarding the conditions we have at that point at that time. And we are preparing other consensus for bladder cancer, for penial cancer as well.

The second thing we are doing a lot is clinical research, not only for tumors that happen with the same frequency in developed countries compared with developing countries. Recently, we published a paper that we had the opportunity to present in the oral session of ASCO two years ago. It was the first randomized trial of known ADT regimens compared with ADT basic regimens in metastatic or advanced prostate cancer. We are very honored to be part of the oral session of ASCO, which is really difficult because of the super selection of the abstracts.

But I think our role, asides from the tumors that have been common in many places in the world, is to focus in tumors that particularly have a high instance in developing countries like Brazil. And one other example is penial cancer. In Maranhao, which is a state in the north part of the country, is the highest incidence of penial cancer in the world. So we are finishing a trial of chemotherapy and immunotherapy with a checkpoint inhibitor in penial cancer. We may have the results for next year. And we are about to start a randomized trial in patients with metastatic penial cancer as well, similar to vulvar cancer, which is another cancer that not always, but is related to HPV.

So we build up a really strong platform in immunotherapy, in HPV positive tumors, which unfortunately have a very high incidence developing countries in Latin America, Africa, Middle East, and so on. So we are focused on these tumors, why? Because the incidence in our region is so high because the investments proportionally compared with other tumors, such as prostate cancer, breast cancer, colon cancer are solo. So this is the second area that have been working a lot.

And third, we have been working a lot as a community in trying to improve and decrease the bureaucracy facilitating access to clinical trials in the region. Because we do think that this is one of the solutions to try to balance the poverty in the region. And also the efficiency regarding infrastructure in many areas. We do think that research who have been supported by pharmas has been incredible and a smart solution to provide to patients, at least the best gold standard and maybe some newer strategy that may be better in the future than what you do have now. In places where people do not have a drug that is basic when you don't have a basic care, but with research, these patients will have a super, super monitoring super treatment and we do think that is really, really a good strategy to improve research care in Brazil.

In fact, we do have a social institute and we are building up research centers in the poor areas of the country. So hostels, there are public hostels that do not have research and in the social institute that I'm a co-founder, we raise money. And with this money, we are building up research centers. So now we are starting six research centers in the country with three more to go for next year.

Phillip Koo: That is amazing. To hear about those three pillars that you're working on, I think will have such a tremendous impact, obviously in Latin America. But I think it'll have waves across the whole globe. And I think on behalf of UroToday and Prostate Cancer Foundation, I have no doubt. We're very excited to bring more visibility to the work that you're doing down here, to the whole world.

And so for those of you are thinking about attending this meeting, or haven't, make sure you put it on your calendar for next year and attend. I think it's a really worthwhile time and a lot of great things are going to come here. So just thank you so much for joining us today.

Fernando Maluf: Thank you very much. It's great to see you. It's great to talk to you today.