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Background: Cancer remains one of the leading causes of morbidity and mortality worldwide, with conventional treatment strategies limited by systemic toxicity, therapeutic resistance, and tumor heterogeneity. The emergence of nanotechnology offers innovative solutions to these challenges, enabling targeted drug delivery, controlled release, and theranostic integration.Objective: This review synthesizes recent progress in cancer nanomedicine, highlighting therapeutic platforms, omics-driven personalization, and clinical translation between 2019 and 2024.Methos: We discuss the major classes of therapeutic nanoplatforms including lipid-based systems, polymeric nanocarriers, inorganic nanoparticles, and hybrid or bioinspired designs detailing their mechanisms of action in targeted delivery, photothermal therapy, and multimodal treatment. Advances in genomics, transcriptomics, proteomics, and metabolomics are explored for their role in guiding nanocarrier design, with emphasis on artificial intelligence–enabled multi-omics integration for precision oncology. Clinical trial progress across liver, lung, pancreatic, breast, and brain cancers demonstrates improved tolerability, patient quality of life, and incremental survival gains, though translation remains constrained by tumor heterogeneity, blood–brain barrier penetration, scalability, cost, and regulatory hurdles.Conclusion: Cancer nanomedicine stands at a pivotal juncture advancing beyond incremental improvements to become a cornerstone of precision oncology. By uniting nanoscale engineering, multi-omics, artificial intelligence, and innovative clinical strategies, the field holds the potential to transform cancer therapy in the decade ahead.