Purpose: Lung cancer cells frequently exhibit marked chromosome instability. We postulated that alterations of the double-strand break repair genes (BRCA1, BRCA2, and XRCC5) might be involved in lung cancer. Patients and Methods: We examined the loss of protein and mRNA expression and the 5 ¶CpG hypermethylation and allelic imbalance of the BRCA1, BRCA2, and XRCC5 genes in 98 non^small cell lung cancer (NSCLC) samples. Anchorage-dependent growth after reexpression of these genes was examined in a lung cancer cell line that originally lacked BRCA1and BRCA2 expression. Results: The data indicated that low protein expression of BRCA1 and BRCA2 was frequent in lung adenocarcinomas (42-44%), whereas low XRCC5 protein expression was more prevalent among squamous cell carcinoma (32%). In addition, low BRCA1 expression was significantly associated with low RB expression, especially in lung adenocarcinoma. Concurrent alterations in XRCC5 and p53 were the most frequent profiles in smoking patients. Importantly, low mRNA and protein expressions of BRCA1, BRCA2, and XRCC5 were significantly associated with their promoter hypermethylation. 5-Aza-2 ¶-deoxycytidine treatment of NSCLC cells showed demethylation and reexpression of the BRCA1 and BRCA2 genes and reduced anchorageindependent growth. Conclusions: Our retrospective study provides compelling evidence that low mRNA and protein expression in the BRCA1/BRCA2 and XRCC5 genes occur in lung adenocarcinoma and squamous cell carcinoma, respectively, and that promoter hypermethylation is the predominant mechanism in deregulation of these genes. Alteration of the double-strand break repair pathway, perhaps by interacting with p53 and RB deregulation, is important in the pathogenesis of a subset of NSCLC.Lung cancer is one of the most common malignancies, making it very important to identify the associated gene(s) involved. We previously did a genome-wide loss of heterozygosity (LOH) study in 71 primary surgically resected non -small cell lung cancer (NSCLC) tumors in which a high mean LOH frequency was reported, indicating the presence of chromosome instability in NSCLC (1). Chromosome instability may be caused by failure in the repair of DNA double-strand breaks (DSB; ref. 2). Interestingly, the chromosome regions at 2q33-35 and 13q12.3, which included gene loci encoding the XRCC5 (Ku80) and BRCA2 (breast cancer 2) DSB repair proteins, respectively, showed a high frequency of LOH in NSCLC tumors (1). We therefore postulated that alterations of genes in chromosomal stability control pathways, such as DSB repair genes (BRCA1, BRCA2, and XRCC5), may be involved in NSCLC tumorigenesis.Two distinct and complementary mechanisms, homologous recombination and nonhomologous end joining, are involved in the repair of detrimental DSBs in mammalian cells (2, 3). The breast tumor suppressors BRCA1 and BRCA2 have been shown to interact with DNA damage -induced Rad51 protein to form foci on DSBs (4, 5). Mouse Brca1-and Brca2-deficient embryonic stem cells show a reduced efficiency ...