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Research in cancer drug development has witnessed a rapid evolution over the past decades, which aims to develop active biological interventions and control cancer-promising candidates that regulate several types of cancer-specific genes at both transcriptional and post-transcriptional level. They include antisense oligonucleotides, ribozymes, small interference RNA (siRNA), different aptamers, and DNAzymes and decoy ribonucleotides. In this chapter, we have discussed these different classes of nucleic acid therapeutics, their applications in the treatment of different types of cancers, their advantages over other treatment regimens including protein-targeted therapies, small molecules, etc., and their limitations. One of these limitations is that they require chemical modifications to escape from enzymatic degradation in the cells. Also, nucleic acids often require various types of drug delivery systems for optimal delivery to the target tissues and cells. They further improve the stability of nucleic acids in the cells, facilitate their internalization, and enhance the target affinity. We have also described different types of delivery platforms in this chapter, including their recent advancements and challenges in the field. The burgeoning number of nucleic acid therapeutics have been approved today at different stages of clinical trials. While conventional treatment strategies induce transient therapeutic effects by targeting the proteins instead of the underlying causes, nucleic acid therapeutics provide long-lasting and often curative effects by gene inhibition, addition, edition, as well as replacement. In this chapter, we discuss the recent state-of-the-art clinical strategies using nucleic acid therapeutics. We explain the rationale behind their development, chemical modifications, and delivery.