<p>Cancer is a leading cause of mortality worldwide, with poor prognosis, high recurrence, and limited survival. Conventional therapies such as surgery, radiotherapy, chemotherapy, photodynamic therapy, and supportive care often fail due to systemic toxicity, drug resistance, and collateral damage to healthy tissues. To overcome these hurdles, metal–organic frameworks (MOFs) have emerged as next-generation smart nanocarriers. MOFs have emerged as promising nanocarriers for cancer therapy, offering advantages over conventional drug delivery systems. MOFs are composed of metal ions and organic linkers, forming highly porous structures with tunable properties. Their unique features, including high surface area, controllable pore size, and versatile functionalization, enable enhanced drug loading, targeted delivery, and stimuli-responsive release. Preclinical studies have demonstrated the potential of MOFs in various cancer types, such as pancreatic, colon, skin, brain, breast, prostate, and liver cancers. MOF-based formulations have shown improved therapeutic efficacy, reduced side effects, and the ability to overcome drug resistance. Strategies such as surface modification, drug encapsulation, and combination with other therapeutic modalities have further enhanced their performance. However, challenges remain in terms of biocompatibility, long-term safety, and scalable production. Future research should focus on elucidating the underlying biological mechanisms, optimizing formulations for specific cancer types, and conducting comprehensive in vivo studies to facilitate clinical translation. With continued advancements, MOF-based approaches hold great promise for precision cancer therapy, offering the potential for more effective, targeted, and personalized treatments.</p> Graphical Abstract <p></p>