6-Gingerol is the bioactive ingredient in raw ginger that inhibits arginase and helps convert M2 (tumor-protecting) macrophages into a M1 (tumor-attacking) phenotype. This is an important area of immune resistance and immune checkpoint failure. Also, Lo Russo, et al. showed that macrophages might be an important mechanism that resulted in hyperprogression (rapid cancer growth) with the treatment of PD-1/PD-L1 inhibitors. Hyperprogression is a major concern with this type of immune checkpoint therapy as it results in reduced survival that is actually caused by the therapy when patients are treated with drugs such as Keytruda and Opdivo.