DNA topoisomerase I (Top1) is the sole target of camptothecin (CPT) and other Top1 poisons [1] that are widely used drugs for treatment of colon cancer and other malignancies. Our previous studies have shown that Top1 is also an important target for the fluoropyrimidine polymer F10 reviewed in [2], and that Top1 poisoning plays an important, but relatively undefined role in thymineless death (TLD), the process by which inhibiting de novo thymidylate synthesis causes DNA damage and cell death. While Top1 poisoning is an important aspect of TLD, thymidine deprivation may also cause DNA damage by Top1-independent pathways, such as replication fork collapse, and these multiple sources of DNA damage may provide the basis for the very strong potency of F10 relative to alternative DNA damaging agents observed for many types of malignant cells. Elucidating the DNA repair pathways activated in cells treated with F10 relative to CPT can provide insight into how Top1 poisoning induced by fluoropyrimidine drugs differs from traditional Top1 poisons, and also clarify which aspects of the DNA damage response are activated by Top1-independent processes. Top1 relieves DNA torsional stress generated during replication and transcription by nicking supercoiled DNA allowing relaxation to proceed via controlled rotation [3], and then re-ligating the nick [4] to restore the DNA duplex. CPT forms a ternary complex with Top1 and the nicked DNA resulting in formation of a Top1 cleavage complex (Top1cc) that, if not repaired, can lead to DNA double-strand breaks (DSBs) through collision with advancing