Amlodipine with letrozole as maintenance post chemotherapy –targeting calcium calcinuerin calmodulin pathway and aromatase inhibitor indisseminated Endometrioid adenocarcinoma of the endometrium a – A case report

Background: 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 cytotoxicT cell. Clinical case; 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 is now disease free since last 3 years. Conclusion: 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. ¹ Modulation of Calcium influx can modify the T cell activation and proliferation ¹ .Estrogen plays critical role in the upregulation of calcium related proteins. Calcium channel blockers(CCB) likeamlodipine, hence can be considered for repurposingin thetreatment of endometrial cancer. ² Amlodipine a CCB can be used along with letrozole especially in female reproductive tract malignancies like endometrial malignancies are concerned.