Castle Biosciences Inc
NASDAQ:CSTL
Castle Biosciences Inc
Castle Biosciences, Inc. is a commercial-stage dermatological cancer company, which engages in the provision of genomic information for physicians and patients. The company is headquartered in Friendswood, Texas and currently employs 342 full-time employees. The company went IPO on 2019-07-25. The company is focused on providing physicians and their patients with personalized, clinically actionable information to clinicians and their patients to inform treatment decisions and improve health outcomes. The firm markets five multi-analyte assays with algorithmic analysis (MAAA) tests for use in the dermatologic, ocular and gastroenterology fields: DecisionDx-Melanoma, DecisionDx-SCC, Comprehensive Diagnostic Offering (CDO), DecisionDx-UM and TissueCypher Barrett’s Esophagus Assay. DecisionDx-Melanoma is risk stratification gene expression profile (GEP) test developed to identify the risk of metastasis for patients diagnosed with invasive cutaneous melanoma. DecisionDx-SCC, a 40-gene expression profile test that uses an individual patient’s tumor biology to predict individual risk of squamous cell carcinoma (SCC) metastasis for patients with one or more risk factors.
Castle Biosciences, Inc. is a commercial-stage dermatological cancer company, which engages in the provision of genomic information for physicians and patients. The company is headquartered in Friendswood, Texas and currently employs 342 full-time employees. The company went IPO on 2019-07-25. The company is focused on providing physicians and their patients with personalized, clinically actionable information to clinicians and their patients to inform treatment decisions and improve health outcomes. The firm markets five multi-analyte assays with algorithmic analysis (MAAA) tests for use in the dermatologic, ocular and gastroenterology fields: DecisionDx-Melanoma, DecisionDx-SCC, Comprehensive Diagnostic Offering (CDO), DecisionDx-UM and TissueCypher Barrett’s Esophagus Assay. DecisionDx-Melanoma is risk stratification gene expression profile (GEP) test developed to identify the risk of metastasis for patients diagnosed with invasive cutaneous melanoma. DecisionDx-SCC, a 40-gene expression profile test that uses an individual patient’s tumor biology to predict individual risk of squamous cell carcinoma (SCC) metastasis for patients with one or more risk factors.
Revenue Beat: Castle Biosciences reported Q4 revenue of $87 million and full year 2025 revenue of $344.2 million, exceeding guidance.
Growth Drivers: Core tests DecisionDx-Melanoma and TissueCypher drove results, with TissueCypher report volume up 86% year-over-year.
Test Adoption: DecisionDx-Melanoma saw 9% volume growth in 2025, maintaining high single-digit growth for the second year; TissueCypher added over 2,000 new clinicians.
Margin Decline: Gross margin for 2025 dropped to 69.2% from 78.5% in 2024, impacted by a one-time amortization expense and loss of certain revenue streams.
Guidance: 2026 total revenue is expected to be $340-$350 million, with core test growth offsetting minimal AdvanceAD-Tx contribution and no DecisionDx-SCC revenue.
Pipeline Progress: AdvanceAD-Tx launched on a limited basis with strong early interest; material revenue impact expected in 2027-2028.
Net Loss: The company posted a net loss of $24.2 million for 2025, compared to net income of $18.2 million in 2024.
Strong Cash Position: Ended 2025 with $299.5 million in cash, cash equivalents, and marketable securities.
