Amlodipine with letrozole as maintenance post-chemotherapy: targeting calcium calcineurin calmodulin pathway and aromatase inhibitor in disseminated endometrioid adenocarcinoma of the endometrium-a case report.

World is now clinging to immune checkpoint inhibitor in almost every type of cancer. PD-1 and PD-L1 inhibitor are taking over the treatment algorithm. But cost is an issue; we have a perspective to target energy mechanism of cytotoxic T cells to modulate the representation of PD-1 receptor so as to increase immunogenicity of cytotoxic T cells. Cellular energy mechanism is largely dependent on calcium channels and pharmacological modulation of it may help in modulating response of cytotoxic T cell. We hereby present a case of endometroid adenocarcinoma of endometrium successfully treated with CCB and hormonal treatment after a short course of chemotherapy (paclitaxel 80 mg/m2 weekly and carboplatin AUC-2) given on weekly basis; she is still in remission; to begin with, she was a case of stage IV ca endometrium due to peritoneal seeding of the disease (TNM & FIGO), but gradually, her stage reversed back to stage 1 (TNM), and after hysterectomy, she is now disease free since last 3 years. This case study hints at possible role of calcium channel blockers (CCB) and calcium modulation, which plays a pivotal role in the energy mechanism of cytotoxic T cells (Feske et al. in Nat Immunol 2(4):316-24, 2001). Modulation of calcium influx can modify the T cell activation and proliferation (Feske et al. in Nat Immunol 2(4):316-24, 2001). Estrogen plays critical role in the upregulation of calcium related proteins. Calcium channel blockers (CCB) like amlodipine, hence, can be considered for repurposing in the treatment of endometrial cancer (Huang et al. in Int J Biol Sci 18(3):1065-1078, 2022). Amlodipine, a CCB, can be used along with letrozole especially in female reproductive tract malignancies like endometrial malignancies which are concerned.