Intravenous iron improves the efficacy of recombinant human erythropoietin (rHuEPO) in anemic cancer patients undergoing chemotherapy. Lactoferrin is a naturally occurring iron-binding protein that also possess immunomodulating activity. This open-label, randomized, prospective trial tested the safety and efficacy of treatment with oral lactoferrin versus IV iron, both combined with rHuEPO, for the treatment of anemia in 148 advanced cancer patients undergoing chemotherapy. All patients received subcutanesou rHuEPO-beta 30,000 UI once weekly for 12 weeks, and were randomly assigned to ferric gluconate (125 mg IV weekly) or lactoferrin (200 mg/day). Both arms showed a significant hemoglobin increase. No difference in the mean hemoglobin increase or the hematopoietic response, time to hematopoietic response, or mean change in serum iron, C-reactive protein, or erythrocyte sedimentation rate were observed between arms. Ferritin decreased in the lactoferrin arm (denoting a good response for this type of anemia) whereas it increased in the IV iron arm. These results show similar efficacy for oral lactoferrin and for i.v. iron, combined with rHuEPO, for the treatment of anemia in advanced cancer patients undergoing chemotherapy. (Oncologist. 2010;15(8):894-902.) PMID: 20647390.
