13th International UroOncology Congress in Brazil

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Philip Koo: Hello, 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 Dr. Having Fernando Maluf with us, who really needs no introduction. He was such a pioneer in GU cancer in Latin America, particularly in Brazil, and was very fortunate to be able to speak with him on a wide variety of topics. So first of all welcome.

Fernando Maluf: Philip, thank you. It is a great pleasure to see you again. We met many, many years ago and we keep seeing each other and I am delighted that you are coming to Brazil and enjoying this meeting which is fantastic.

Philip Koo: Thanks very much. I agree. It’s so nice to be able to reconnect with people now that we hopefully have the issues with COVID behind us. So this meeting is the 13th, first of all, congratulations. I’ve heard so many wonderful things and it’s great for us to be here to really expand the reach. Can you tell us a bit more about how it all started and how you think it will develop in the future?

Fernando Maluf: I am very proud to say that this gathering originally started as a small gathering of no more than 200 people. And not just me, but our team has put a lot of energy into the Brazilian Urology Society, other societies and the hostels working to expand this gathering to make it more popular and visible to the Brazilian community. Not only the community of urologists and oncologists, but also the radiation oncologists, the pathologists, the radiologists and also the other multidisciplinary fields.

So this meeting has really grown a lot. Now we have more than 5,000 people in the audience every year. It’s turning out to be one of the biggest geo-meetings in the world, which is really something to be excited about and proud of for us right now. And we have also expanded to the Latin American colleagues and also to the colleagues around the world. So this is a truly international gathering now.

Apart from the pre-session, we have about 10 parallel courses that can cover very important topics that we don’t have much time for in the pre-session. Also, we have many case reviews and meetings with doctors from across the country to discuss cases in private sessions as well. And as I told you in the enlargement project, now we have a special part of the meeting for abstracts like we have for other international meetings.

So it really turned out to be a very interesting, productive meeting. It’s every year, before it was three days, now it’s four days. We might think about maybe having half a day for next year, we think about it. And this year we have 14 international leaders from Urology, Radiation Oncology and Medical Oncology who came to Brazil to attend the lectures and the clinical case discussions, which is really, really great. And it really raises the bar.

Philip Koo: I absolutely agree. I love the fact that it’s so multidisciplinary. As I went through the agenda and just saw all the disciplines involved and even sessions on nutrition and other areas that are so important to oncology and then got that global perspective, I loved it.

One of the positive effects that we have seen from this type of meeting is the increasing participation of Latin America in clinical trials and research, which is wonderful. And earlier we had Dr. Interviewed Tomba and he spoke about how important LACOG is. Can you talk to us about the future of research from a Brazilian and Latin American perspective?

Fernando Maluf: Well, I think that’s a really important issue for us. We know that the region has many difficulties and limitations in terms of patient care and health projects. One of the things we did as a group was to create and recently publish a very good consensus from the screening to the diagnosis to the therapeutic part of prostate cancer at every stage of the disease for developing countries. So for places where you don’t have all the tools at hand.

I am very happy to be part of the Sungalis consensus brilliantly led by Sioki and Aridos. But in this consensus we vote for the ideal things that unfortunately are not accessible to most parts of the world. This is how we create a very nice consensus that we published in 2020 on JGO, The Journal of Global Oncology. It was eight publications to show doctors what to do if you don’t have this drug available, if you don’t have radiotherapy available at the time, if you don’t have experienced surgeons to do things like radical prostatectomy. That was one of the things we’ve been working on a lot, which is trying to build consensus to help healthcare providers understand how best to manage people in the conditions that we have at this time. And we are preparing another consensus for bladder cancer, also for penile cancer.

Secondly, we do a lot of clinical research, not just for tumors that occur with the same frequency in developed countries as in developing countries. We recently published a paper that we were able to present at the ASCO Oral Session two years ago. It was the first randomized trial of known ADT therapies versus background ADT therapies in metastatic or advanced prostate cancer. We are very honored to be part of ASCO’s oral session, which is really difficult due to the super selection of abstracts.

But I think our role, apart from the tumors that are common in many places around the world, is to focus on tumors that are particularly common in developing countries like Brazil. And another example is penile cancer. Maranhao, a state in the north of the country, has the highest incidence of penile cancer in the world. So we’re completing a study of chemotherapy and immunotherapy with a checkpoint inhibitor in penile cancer. Maybe we’ll have the results for next year. And we’re about to start a randomized trial as well in patients with metastatic penile cancer, similar to vulvar cancer, which is another cancer that’s not always, but is, related to HPV.

So we’re building a really strong platform in immunotherapy, in HPV positive tumors, which unfortunately have a very high incidence in developing countries in Latin America, Africa, the Middle East, etc. So we’re focusing on these tumors, why? Because the incidence in our region is so high because the investments are proportionate compared to other tumors such as prostate cancer, breast cancer, colon cancer alone. So that’s the second area where a lot of work has been done.

And third, we’ve done a lot of work as a community to improve and cut down on the bureaucracy that facilitates access to clinical trials in the region. Because we believe that this is one of the solutions to try to alleviate the poverty in the region. And also the efficiency in terms of infrastructure in many areas. We think research supported by pharmaceutical companies was incredible and a smart solution for patients, at least the best gold standard and maybe a newer strategy that might be better in the future than what you have now. In places where people don’t have medication, that’s easy if you don’t have basic care, but with research, these patients are going to have super, super monitoring, super care, and we think that’s a really, really good strategy to research care in Improve Brazil.

In fact, we have a social institute and are building research centers in the poor areas of the country. So dormitories, there are public dormitories that don’t have research, and in the social institute that I co-found, we collect money. And with this money we build research centers. So now we’re launching six research centers in the country, with three more coming up next year.

Philip Koo: That’s great. I think hearing about these three pillars that you are working on will have a huge impact, obviously in Latin America. But I think there will be ripples all over the world. And I think on behalf of UroToday and the Prostate Cancer Foundation I have no doubt. We’re so excited to make the work you’re doing down here more visible to the world.

So for those of you who are thinking of attending this gathering or have not yet, make sure to put it on your calendar for next year and attend. I think it’s a really worthwhile time and there’s a lot of great things to come here. So thank you for being with us today.

Fernando Maluf: Thanks very much. It’s nice to see you. It’s great talking to you today.

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