Castle Biosciences (NASDAQ:CSTL) Releases Earnings Results, Hits Expectations

Key Points

• Castle reported EPS of ($0.49) in-line with estimates and revenue of about $84M that beat expectations, while management raised 2026 revenue guidance to $345–$355M.
• Core test volumes grew 36% YoY with DecisionDx‑Melanoma and TissueCypher posting record months, and AdvanceAD‑Tx showed early commercial traction with roughly 650 orders and reimbursement clarity expected by end of Q3 2026.
• Profitability is mixed: GAAP gross margin was ~72.8% and net loss narrowed to $14.5M, but adjusted EBITDA remained negative (~$5.1M); the company holds $261.7M in cash and plans a lab expansion while remaining opportunistic on M&A.

Castle Biosciences (NASDAQ:CSTL - Get Free Report) released its earnings results on Wednesday. The company reported ($0.49) EPS for the quarter, hitting analysts' consensus estimates of ($0.49), FiscalAI reports. Castle Biosciences had a negative return on equity of 0.89% and a negative net margin of 7.02%.The firm had revenue of $84.23 million during the quarter, compared to the consensus estimate of $79.23 million.

Here are the key takeaways from Castle Biosciences' conference call:

• Q1 revenue was $83.7 million and management raised 2026 revenue guidance to $345–$355 million (up from $340–$350M), implying high-teens to low-20s growth ex DecisionDx‑SCC and IDgenetix.
• Core test volumes grew 36% year-over-year with DecisionDx‑Melanoma at 10,021 reports (+16% YoY) and TissueCypher at 11,745 reports (+58% YoY), each posting record months in March (TissueCypher also in April).
• AdvanceAD‑Tx showed early commercial traction with ~650 orders in Q1 and published prospective data that stratifies patients likely to respond faster to JAK inhibitors; management expects reimbursement clarity by end of Q3 2026.
• Profitability signals are mixed: GAAP gross margin was 72.8% (adjusted gross margin 75.6%), net loss narrowed to $14.5 million, but adjusted EBITDA remained negative $5.1 million (impacted by prior-year non‑cash items).
• Balance sheet and capacity moves support growth: cash and marketable securities were $261.7 million at March 31, 2026, the company plans an expanded Phoenix lab (no expected margin hit) and remains opportunistic on M&A.

Castle Biosciences Stock Performance

CSTL stock traded up $0.15 during trading on Wednesday, hitting $24.75. 701,819 shares of the company traded hands, compared to its average volume of 295,398. The stock's 50-day simple moving average is $25.62 and its 200 day simple moving average is $32.17. The company has a debt-to-equity ratio of 0.02, a current ratio of 5.26 and a quick ratio of 5.11. The company has a market cap of $749.93 million, a PE ratio of -29.12 and a beta of 1.11. Castle Biosciences has a 1 year low of $14.59 and a 1 year high of $44.28.

Wall Street Analyst Weigh In

A number of equities research analysts recently commented on CSTL shares. Zacks Research raised Castle Biosciences from a "hold" rating to a "strong-buy" rating in a report on Monday, April 27th. Guggenheim lifted their target price on Castle Biosciences from $43.00 to $47.00 and gave the stock a "buy" rating in a report on Monday, January 26th. KeyCorp reaffirmed an "overweight" rating and set a $50.00 target price on shares of Castle Biosciences in a report on Thursday, January 29th. Lake Street Capital lifted their target price on Castle Biosciences from $35.00 to $52.00 and gave the stock a "buy" rating in a report on Monday, January 12th. Finally, Robert W. Baird lifted their target price on Castle Biosciences from $41.00 to $44.00 and gave the stock an "outperform" rating in a report on Friday, February 27th. One equities research analyst has rated the stock with a Strong Buy rating, eight have issued a Buy rating and one has given a Sell rating to the company. Based on data from MarketBeat.com, the stock has an average rating of "Moderate Buy" and a consensus target price of $46.14.

Insider Buying and Selling

In related news, Director G Bradley Cole sold 7,403 shares of Castle Biosciences stock in a transaction that occurred on Thursday, March 5th. The stock was sold at an average price of $28.47, for a total transaction of $210,763.41. Following the completion of the transaction, the director directly owned 19,309 shares in the company, valued at approximately $549,727.23. This trade represents a 27.71% decrease in their ownership of the stock. The sale was disclosed in a legal filing with the Securities & Exchange Commission, which can be accessed through this hyperlink. Also, insider Derek J. Maetzold sold 18,650 shares of Castle Biosciences stock in a transaction that occurred on Tuesday, March 17th. The shares were sold at an average price of $25.93, for a total value of $483,594.50. Following the transaction, the insider owned 22,129 shares of the company's stock, valued at approximately $573,804.97. This represents a 45.73% decrease in their ownership of the stock. The SEC filing for this sale provides additional information. Insiders have sold a total of 74,575 shares of company stock valued at $1,948,344 in the last ninety days. Insiders own 6.10% of the company's stock.

Institutional Trading of Castle Biosciences

A number of institutional investors and hedge funds have recently made changes to their positions in CSTL. Federated Hermes Inc. purchased a new stake in shares of Castle Biosciences in the fourth quarter valued at approximately $26,000. Kemnay Advisory Services Inc. purchased a new stake in shares of Castle Biosciences in the fourth quarter valued at approximately $35,000. Jones Financial Companies Lllp increased its position in shares of Castle Biosciences by 10,592.0% in the first quarter. Jones Financial Companies Lllp now owns 2,673 shares of the company's stock valued at $54,000 after buying an additional 2,648 shares in the last quarter. Tower Research Capital LLC TRC increased its position in shares of Castle Biosciences by 256.9% in the second quarter. Tower Research Capital LLC TRC now owns 2,791 shares of the company's stock valued at $57,000 after buying an additional 2,009 shares in the last quarter. Finally, Russell Investments Group Ltd. increased its position in shares of Castle Biosciences by 63.7% in the third quarter. Russell Investments Group Ltd. now owns 2,508 shares of the company's stock valued at $57,000 after buying an additional 976 shares in the last quarter. 92.60% of the stock is currently owned by hedge funds and other institutional investors.

About Castle Biosciences

Castle Biosciences, Inc is a molecular diagnostics company specializing in the development and commercialization of prognostic and diagnostic tests for patients with dermatologic conditions. The company's proprietary portfolio of genomic assays is designed to improve risk assessment and guide clinical decision-making for individuals with skin cancers and other skin-related diseases. By combining genomic data with advanced statistical algorithms, Castle Biosciences seeks to provide actionable insights that help physicians tailor treatment plans and monitoring strategies.

The company's flagship test, DecisionDx-Melanoma, evaluates the probability of metastasis in patients diagnosed with cutaneous melanoma, supporting more personalized surveillance and therapeutic approaches.

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