TOP1 and neoplasm: TOP1 inhibitor-mediated DNA damage can stimulate both innate and adaptive immune responses through multiple mechanisms: (1) release of DNA fragments after DNA damage, which activates the stimulator of interferon genes (STING) pathway [87,88,89]; (2) DNA damage-induced release of tumor microvesicles, which increase immune activation [90,91]; and (3) DNA damage-induced antigen presentation via tumor cell MHC class I molecules, which enhance recognition of tumor cells by immune cells [87,88,89,90,91,92].