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Hydrogel-based drug delivery systems have emerged as promising platforms for targeted anti-cancer therapies due to their biocompatibility, controlled drug release profiles, and ability to localize treatment within tumor tissues. These hydrophilic polymer networks facilitate prolonged and site-specific delivery of therapeutic agents, thereby enhancing efficacy while minimizing systemic side effects. Recent advancements in materials science have led to the development of smart hydrogels that respond to tumour-specific stimuli—such as pH, temperature, redox conditions, and enzymatic activity—enabling precise spatiotemporal drug release within the tumor microenvironment. This review explores the design and application of such hydrogel systems, including stimuli-responsive platforms, targeted ligand incorporation, and nanocomposite formulations capable of co-delivering therapeutics and imaging agents. Innovative features such as injectability, self-healing capacity, and shape adaptability further enhance clinical utility by conforming to irregular tumor geometries. Preclinical findings demonstrate improved therapeutic outcomes and safety profiles, and early-phase clinical trials suggest strong potential for integration into personalized cancer treatment regimens. Overall, hydrogel-based delivery systems represent a versatile and minimally invasive approach for next-generation oncology therapies, offering multifunctional capabilities tailored to patient- and tumour-specific requirements.