practice points• A normal cycling cell can encounter up to 30,000 DNA damage events in 1 day, which are repaired by distinct pathways that target and repair specific lesions.• Platinum-based chemotherapeutics exert toxicity through the formation of irreparable base adducts and DNA crosslinks, which direct the cancerous cells towards apoptotic death.• The selective pressure exerted on the tumor eventuates genetic drift and may provide the cancerous cells resistance to many anticancer therapies.• Several distinct while overlapping pathways exist within the cell to detect and repair the various DNA damage lesions that may occur.• The inaccurate repair of DNA lesions may lead to mutations within the cell and drive tumorigenesis.• Many cancers contain mutations in DNA repair genes, for example, more than 90% of small cell lung cancers and 50% of all non-small-cell lung cancers carry mutations in tP53, encoding the important tumor suppressor, p53.• Many anticancer therapies, including platinum-based chemotherapeutics and replication inhibitors, induce apoptosis within the cell through the formation of irreparable DNA damage.• The deregulation of DNA repair proteins within cells may provide an attractive therapeutic window. Such an approach is exemplified by the PARP inhibitors, which show potential use in the treatment of cancers deficient of functional BRCA1 or BRCA2. In addition, these drugs may show increased efficacy in combination with DNA-damaging agents.• Resistance to platinum-based agents may be acquired through multiple mechanisms, including mutation or deregulation of DNA repair proteins, alteration of membrane transport protein activity and chromatin remodeling.