Unknown to early investigators, DNA damage and repair has been a major focus of anticancer therapy from the beginning of clinical oncology. From the early days of using x-irradiation, to the development of nitrogen mustard analogs, to today's more sophisticated approaches, DNA damage and repair has strongly impacted our ability to successfully treat human malignancy. This area of basic, translational, and clinical science is very broad. The traditional focus of DNA damage and repair has been on diseases such as Xeroderma pigmentosum, and attempting to understand the basic molecular mechanisms of DNA repair processes. It is only recently that we have begun to appreciate how we might modulate these processes to improve our ability to advance cancer care. No fewer than 10 separate DNA repair processes are operative in higher organisms, and the total number of separable processes could be substantially higher. Some of our most useful clinical agents depend on causing DNA damage that is repaired by nucleotide excision repair. X-irradiation induces damage that is mostly repaired by base excision repair and double-strand break repair. We are now learning how to modulate select DNA repair pathways to benefit patients with breast cancer and other malignancies. Clin Cancer Res; 16(18); 4511-6. ©2010 AACR.DNA damage and repair is a subject of enormous breadth and depth. We commonly underestimate the importance of DNA damage and repair in the successful treatment of cancer, and, in general, also underestimate the overall importance of DNA damage and repair in oncology. For example, the most widely used class of anticancer compounds is the platinum series of agents, cisplatin, carboplatin, and oxaliplatin (1, 2). One or more of these agents represents the cornerstone of the current standard of care in the vast majority of solid tumors, including lung cancer, head and neck cancers, upper and lower gastrointestinal malignancies, genitourinary malignancies, and solid tumors of childhood. Alkylating agents have long been the backbone of treatment regimens for lymphomas, and other hematologic malignancies. Radiation therapy is critically important to cure, in a large range of early stage diseases. Despite its importance, much less is written about DNA repair than many of the other common subcellular processes that govern cancer causation and cancer treatment.DNA damage occurs in many forms, as a result of a range of many different types of exposures. Similarly, DNA repair is executed in a variety of ways; these processes having evolved over many millions of years, with the earliest of versions seen in the most rudimentary unicellular life forms. At a minimum, most would agree that the following are distinct pathways of DNA repair that occur in higher organisms: nucleotide excision repair (NER), base excision repair (BER), mismatch repair (MMR), doublestrand break repair (DSBR), direct reversal, translesion synthesis, homologous recombination, and nonhomologous end-joining.In this issue of Clinical Cancer Research, we touc...