Vrinda Gupta, Dinesh Kumar, Sonia Gupta, Rajni Tanwar, Nicky Kumar Jaiswal, Md Moidul Islam, Shivani Singh, Niraj Choudhary, S. Gowri, Thomas Webster, Md Faiyazuddin
Cancer continues to pose a global health challenge, with conventional therapies often limited by non-specific toxicity, drug resistance, and an inadequate therapeutic index. Nanotechnology offers transformative opportunities by enabling targeted drug delivery, improved pharmacokinetics, and integrated diagnostic-therapeutic platforms (termed nanotheranostics). This review highlights key nanocarrier systems including liposomes, polymeric nanoparticles, dendrimers, inorganic nanostructures, carbon-based materials, extracellular vesicles, and hybrid platforms with a focus on human studies and clinical translation. Design strategies (such as passive and active tumor targeting, biomimicry, and stimuli-responsive release mechanisms) are discussed in the context of improving tumor selectivity and minimizing systemic toxicity. Recent innovations, including AI-supported nanomedicine design, smart nanorobots, and cell-mediated delivery systems, are also examined. Although multiple nano-formulations such as Doxil®, Abraxane®, and Vyxeos® have reached clinical use, challenges remain including large-scale manufacturing, regulatory pathways, long-term safety evaluation, and cost-effective global accessibility. This review provides a critical appraisal of current evidence, translational bottlenecks, and emerging opportunities to guide future nanomedicine development. Nanotechnology is poised to become a cornerstone of precision oncology, enabling personalized, safe, and effective cancer treatment paradigms.