The recently started FLUTE project aims to research and develop a platform for secure, privacy-preserving cross-border federated learning, and includes a pilot study on the diagnosis of prostate cancer. While FLUTE's algorithms will scale well to larger number of patients, it does not include work towards handling very large models, and its pilot study has a limited size of about 3500 patients. In the ALTO-FLUTE project, Siemens Romania (SR) will bring (a) a large dataset with 500 million medical images among which 100.000 prostate MRI images and 12.000 prostate MRI images with diagnosed cancer, and (b) significant expertise in training large-scale foundational models which can exploit not only the more expensive fully labelled data but also the more abundant unlabelled data or incomplete patient records. Supported by the existing partners, SR will be integrated in the FLUTE project, will learn new privacy-enhancing technology, will research and develop new secure, privacy-preserving algorithms, and will add extensive new contributions to the pilot study. This effort will significantly enhance FLUTE's impact, and will stimulate the exchange of scientific knowledge and ideas between Romanian researchers and participants of excellent research projects.