DNA topoisomerase I (Top1) generates transient DNA single-strand breaks via the formation of cleavage complexes in which the enzyme is linked to the 3 -phosphate of the cleavage strand. The anticancer drug camptothecin (CPT) poisons Top1 by trapping cleavage complexes, thereby inducing Top1-linked single-strand breaks. Such DNA lesions are converted into DNA double-strand breaks (DSBs) upon collision with replication forks, implying that DSB repair pathways could be involved in the processing/repair of Top1-mediated DNA damage. Here we report that Top1-mediated DNA damage is repaired primarily by homologous recombination, a major pathway of DSB repair. Unexpectedly, however, we found that nonhomologous end joining (NHEJ), another DSB repair pathway, has no positive role in the relevant repair; notably, DT40 cell mutants lacking either of the NHEJ factors (namely, Ku70, DNA-dependent protein kinase catalytic subunit, and DNA ligase IV) were resistant to killing by CPT. In addition, we showed that the absence of NHEJ alleviates the requirement of homologous recombination in the repair of CPT-induced DNA damage. Our results indicate that NHEJ can be a cytotoxic pathway in the presence of CPT, shedding new light on the molecular mechanisms for the formation and repair of Top1-mediated DNA damage in vertebrates. Thus, our data have significant implications for cancer chemotherapy involving Top1 inhibitors.DNA double-strand breaks (DSBs) 1 can be caused by a variety of exogenous and endogenous agents, posing a major threat to genome integrity. If left unrepaired, DSBs may cause cell death (1, 2). Vertebrate cells have evolved two distinct pathways for repairing DSBs, homologous recombination (HR) and nonhomologous end joining (NHEJ) (2-5). The HR reaction requires a wide variety of proteins including Rad51, Rad52, and Rad54 (2), whereas NHEJ relies on Ku (a heterodimer of Ku70 and Ku86), DNA-PKcs, Artemis, Xrcc4, and DNA ligase IV (the LIG4 gene product) (3, 5, 6). The requirement for DNA ligase IV in this pathway is exclusive as other DNA ligases (I and III) are unable to substitute for the ligase function (7,8). In contrast to HR that allows for accurate repair of DSBs, NHEJ is typically an imprecise, error-prone pathway.In accordance with the essential roles of HR and NHEJ in DSB repair, cells deficient in HR or NHEJ have been shown to be highly sensitive to ionizing radiation (7-14). In the chicken B-lymphocyte DT40 cell line (15), the extent of radiosensitivity of RAD54 Ϫ/Ϫ cells is similar to that of DNA-PKcs Ϫ/Ϫ/Ϫ or LIG4 Ϫ/Ϫ cells (8, 14), and RAD54 Ϫ/Ϫ /DNA-PKcs Ϫ/Ϫ/Ϫ double mutant cells are much more radiosensitive than each single mutant (14). These results clearly indicate that HR and NHEJ contribute equally, and independently, to the repair of radiation-induced DSBs.Perturbation of fundamental cellular processes such as DNA replication or the action of DNA topoisomerases often causes DSBs. DNA topoisomerases are ubiquitous nuclear enzymes that participate in many aspects of DNA metabolisms, including DNA ...