Anti-TOP1 payloads, such as deruxtecan or govitecan, could stimulate both innate and adaptive immune response because of their DNA damage mediated effect; different mechanisms have been described, including cyclic GMP-AMP synthase (cGAS)/STING signalling pathway activation [53], DNA damage-induced antigen presentation via tumor cell MHC class I molecules [54], and DNA damage-induced release of tumor microvescicles [55]. This evidence concerns the gene TOP1 and neoplasm.