Clinical Trials

Background: Liver, breast, kidney, and brain cancers remain major contributors to global cancer morbidity and mortality. Conventional therapies are limited by systemic toxicity, drug resistance, and tumor heterogeneity. Smart nanoplatforms offer targeted delivery, controlled release, and theranostic capabilities to address these challenges. Objective: This systematic review evaluates the development and clinical translation of smart nanoplatforms between 2019 and 2024, focusing on their design, omics integration, therapy response, and clinical outcomes in liver, breast, kidney, and brain cancers. Methods: Studies published between 2019 and 2024 were systematically analyzed, encompassing preclinical research, clinical trials, and multi-omics-guided nanoparticle strategies. Nanoplatforms were categorized into lipid-based, polymeric, inorganic, and hybrid/bioinspired systems. The review highlights therapy response, biomarker monitoring, and adaptive approaches informed by omics data. Results: Lipid-based and polymeric nanoparticles demonstrated enhanced tumor targeting and reduced systemic toxicity. Inorganic and hybrid/bioinspired platforms enabled imaging-guided therapy and immune evasion. Integration of genomics, transcriptomics, proteomics, and metabolomics with AI-driven analytics facilitated personalized therapy and adaptive treatment strategies. Clinical trials reported improved patient tolerability, quality of life, and preliminary survival benefits, though translational barriers—including tumor heterogeneity, blood–brain barrier penetration, manufacturing, and regulatory hurdles—remain significant. Conclusions: Smart nanoplatforms represent a transformative approach to precision oncology. The combination of targeted delivery, multi-omics guidance, and AI-driven therapy optimization has the potential to enhance treatment efficacy and patient-specific outcomes. Future research should focus on scalable manufacturing, regulatory standardization, and integration of innovative trial designs to accelerate clinical adoption.