The crucial limitation of most low molecular weight cytostatic drugs, including anthracyclines, is their nonspecific biodistribution causing severe adverse effects during cancer treatment. Recently, nanomedicines such as polymer-based systems have been developed as advanced drug delivery systems. Herein, we report the design, synthesis, and characterization of highly water-soluble polymer-carriers based on N‑(1,3‑dihydroxyprop-2-yl)methacrylamide (DHPMA). Polymers differing in molecular weight, hydrodynamic size, and dispersity were synthesized via free or controlled radical polymerization and conjugated to an anthracycline drug pirarubicin (THP) via a pH-sensitive hydrazone bond achieving up to 21 wt% of THP. The DHPMA copolymers were extensively compared to the well-known drug delivery vectors, N-(2-hydroxypropyl)methacrylamide (HPMA)-based copolymers. Importantly, DHPMA-based conjugates showed excellent hydrophilicity exceeding that of HPMA-based copolymers and did not aggregate even after loading with THP reaching 21 wt%. The DHPMA-based polymer nanomedicines exhibited excellent cytotoxicity, body biodistribution, tumor accumulation, and antitumor efficacy, significantly reducing the side effects and toxicity comparable to HPMA-based systems, thus demonstrating their applicability and suitability as efficient drug carriers.