Einhorn and Donohue pioneered the first multi-agent chemotherapy regimens in adults with metastatic testicular disease in the late 1970s, initially using cisplatin, vinblastine and bleomycin which demonstrated impressive complete remission rates (80% and 74%, respectively) (7, 8). Since that time several co-operative groups have used similar platinum backbones to refine chemotherapy approaches first in adults and then in paediatrics (9-12). Over time renal and ototoxicity prompted a switch from cisplatin to carboplatin, with etoposide and bleomycin (JEB) (10)  which had been shown to be highly efficacious and less toxic by earlier investigators (11, 12).  Subsequently JEb and PEb have been shown to have equivalence in the treatment of standard risk MEGCTs in children (13).