This study introduces a novel fiber-optic drug delivery strategy for synergistic cancer photothermal-chemotherapy. The fiber probe carries photosensitizers in the core and antitumor agents on the surface, mediated by a temperature-responsive hydrogel film. This system enables localized hyperthermia and thermal-stimuli drug release, enhancing drug delivery efficiency and reducing systemic toxicity. Real-time drug release and temperature monitoring are achieved through integrated sensors, including a Mach-Zehnder interferometer and a fiber Bragg grating. Compared to conventional methods, this approach offers precise drug delivery, accurate drug release control, high drug permeability and retention in tumors, and low off-target effects. In vitro and in vivo experiments demonstrate the effectiveness of the fiber-optic drug delivery system, showing complete tumor eradication with minimal side effects. The strategy also provides a versatile platform for drug screening and evaluation, addressing the challenges of drug delivery and toxicity in cancer treatment.This study introduces a novel fiber-optic drug delivery strategy for synergistic cancer photothermal-chemotherapy. The fiber probe carries photosensitizers in the core and antitumor agents on the surface, mediated by a temperature-responsive hydrogel film. This system enables localized hyperthermia and thermal-stimuli drug release, enhancing drug delivery efficiency and reducing systemic toxicity. Real-time drug release and temperature monitoring are achieved through integrated sensors, including a Mach-Zehnder interferometer and a fiber Bragg grating. Compared to conventional methods, this approach offers precise drug delivery, accurate drug release control, high drug permeability and retention in tumors, and low off-target effects. In vitro and in vivo experiments demonstrate the effectiveness of the fiber-optic drug delivery system, showing complete tumor eradication with minimal side effects. The strategy also provides a versatile platform for drug screening and evaluation, addressing the challenges of drug delivery and toxicity in cancer treatment.