Background <p>Cancer therapy is frequently limited by poor tumor selectivity, systemic toxicity, unfavorable pharmacokinetics, and therapeutic resistance. Nanocarrier-based drug delivery systems have emerged as promising pharmaceutical platforms for improving therapeutic precision, enhancing tumor accumulation, and enabling personalized cancer treatment strategies.</p> Area covered <p>This review discusses major nanocarrier systems employed in precision oncology, including liposomes, polymeric nanoparticles, dendrimers, carbon nanotubes, and quantum dots, with emphasis on their pharmaceutical design, physicochemical properties, and therapeutic relevance. Particular attention is given to tumor-targeting approaches based on enhanced permeability and retention-mediated passive targeting and ligand-mediated active targeting. The review further examines multifunctional and theranostic nanoplatforms integrating imaging and therapy within a single system to support real-time monitoring of therapeutic response. In addition, recent advances in biomarker-guided therapy, stimuli-responsive drug delivery, combination therapeutics, and clinically translated nanoformulations are discussed alongside current challenges associated with biodistribution variability, large-scale manufacturing, long-term safety, and regulatory complexity.</p> Expert opinion <p>Nanocarrier-based drug delivery systems continue to demonstrate substantial potential for advancing precision oncology by improving drug delivery efficiency, therapeutic selectivity, and patient-tailored treatment outcomes. Future progress in pharmaceutical engineering, scalable manufacturing, biomarker-driven stratification, and clinically translatable multifunctional nanoplatforms may further accelerate the integration of nanomedicine into routine cancer management and personalized therapeutic interventions.</p> Graphical Abstract <p></p>