Chemotherapy is a prime tool for cancer clinical therapy. The effectiveness has been improved considerably with the assistance of nanotechnology. However, it still meets the challenge of unsatisfied therapeutic effects caused by multidrug resistance and uncontrollable drug release. For further enhancement of the treatment performance, we develop a kind of microRNA-responsive nanomedicine that uses the biomarker microRNA-21 as a trigger of cascaded killing effects on cancer cells, including chemotherapy and gene silencing. The nanomedicine consists of a gold nanoparticle core and a DNA layer. Strand migrations within the layer can accurately control the events of anticancer drug doxorubicin release and multidrug-resistant-associated protein 1 downregulation, yielding an alleviation of multidrug resistance and enhanced killing on cancer cells. This work demonstrates a microRNA-responsive nanomedicine in combination with chemotherapy and gene silencing, which paves the way to the advancement of DNA-based nanomedicine for cancer theranostics.