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This is a very important article. It says that using Dexamethasone hurts the immune system. Sometimes we need it - it is used to treat swelling of the brain which can cause death, but we should be careful and consider other treatments if possible, Temozolomide has a similar effect. This means it might be best to start immunotherapies before starting Temozolomide, and before the surgery that necessitates the use of Dexamethasone. And also keep the dosage of Dexamethasone to a minimum if possible NOTE: Dexamethasone is the one drug that you can NOT just stop cold turkey - that can kill you. There is a weaning schedule that has to be followed closely so you can not adjust the dose yourself. You need to talk to your doctors about this.