Here is a one(and a half?)-liner: group by letter (for which you need to sort before), then take the sum of the second entries of your tuples.
from itertools import groupby
from operator import itemgetter
data = [('A', 100), ('B', 50), ('A', 50), ('B', 20), ('C', 10)]
res = [(k, sum(map(itemgetter(1), g)))
for k, g in groupby(sorted(data, key=itemgetter(0)), key=itemgetter(0))]
print(res)
// => [('A', 150), ('B', 70), ('C', 10)]
The above is O(n log n) — sorting is the most expensive operation. If your input list is truly large, you might be better served by the following O(n) approach:
from collections import defaultdict
data = [('A', 100), ('B', 50), ('A', 50), ('B', 20), ('C', 10)]
d = defaultdict(int)
for letter, value in data:
d[letter] += value
res = list(d.items())
print(res)
// => [('B', 70), ('C', 10), ('A', 150)]
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