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hat changes in the epigenetic regulation of genes may contribute to impaired muscle function in later life. The gene ENPEP encodes glutamyl aminopeptidase, which can cut N-terminal aspartic acid from angiotensin II, and is related to tumorigenesis and immune microenvironment, however, the association between the expression of ENPEP and benefits of immune checkpoint inhibitors (ICIs) has had no investigation. We assess the immunotherapeutic predictive performance of ENPEP expression and mutation in multiple cohorts, including one discovery