Bone cancer remains a significant clinical challenge due to  the high incidence and marked heterogeneity of malignant  lesions affecting skeletal tissue. Current treatment strategies  primarily aim to prolong patient survival and improve quality  of life rather than achieve complete remission, while conventional therapies are often associated with substantial side  effects. In recent years, biomaterial-based approaches— particularly polymeric and composite drug delivery systems  in the form of scaffolds or bone cements—have emerged  as promising alternatives. These platforms enable localized  therapeutic delivery and can be synergistically combined with  magnetic hyperthermia or photothermal therapy to enhance  anticancer efficacy. Moreover, many such materials exhibit  antibacterial properties, offering additional protection against  postoperative infections. This review examines the key challenges and recent advances in biomaterial-based strategies for the treatment of primary bone cancers and bone  metastases, encompassing both conventional therapeutic  approaches and emerging multifunctional material systems.