The role of vanadium binding to transferrin (Tf) in the biological activities of vanadium-based drugs is a matter of considerable debate. In order to determine whether V(V) and/or V(IV) binding to Tf (in apo, monoferric(III), and diferric(III) forms) enhances or inhibits biological activities, cellular V uptake and in vitro antiproliferative activity were examined in the presence and absence of different forms of Tf and other biomolecules under normoxic conditions. These data were combined with studies on V-Tf binding in cell culture medium and its role in Tf interactions with transferrin receptor 1 (TfR1), using the biolayer interferometry (BLI) model of the Tf cycle that was developed in our group. The results showed that both V(V) and V(IV) oxidation states efficiently bind to vacant Fe(III) binding sites of Tf even in the presence of a 20-fold molar excess of albumin, although V does not displace Tf-bound Fe(III) under these conditions. Binding of V(V) or V(IV) to Tf in cell culture medium drastically reduced its cellular uptake and antiproliferative activity in the A549 (human lung cancer) cell line that expresses TfR1. BLI and gel electrophoresis studies showed that V(V/IV) binding to partially Fe(III) saturated Tf did not enhance the affinity of Tf binding to TfR1 at pH 7.4 but did disrupt Tf conformational changes under endosome-mimicking conditions (pH 5.6, 0.10 mM citrate). Hence, it is postulated that the absence of a significant cellular uptake of Tf-bound V(V/IV) is likely to be due to the return of undissociated V(V/IV)-Tf adducts to the cell surface after the endosomal step. Collectively, these data show that the biotransformation of V-based drugs leads to V(V/IV)-Tf binding in the blood serum and inhibits, rather than enhances, the biological activity of such drugs under aerobic conditions. These results indicate that the design of V-based drugs that are stable enough to survive in the blood, enter cells intact, and release the active components intracellularly is likely to be required for their clinical success.