Castle Biosciences (NASDAQ:CSTL) Releases Earnings Results

Castle Biosciences (NASDAQ:CSTL) issued its quarterly earnings data on Thursday. The company reported ($0.08) earnings per share (EPS) for the quarter, beating the consensus estimate of ($0.21) by $0.13, FiscalAI reports. The business had revenue of $81.88 million during the quarter, compared to analysts’ expectations of $81.19 million. Castle Biosciences had a positive return on equity of 1.73% and a negative net margin of 3.56%.

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

• Castle reported Q4 revenue of $87.0 million and full-year 2025 revenue of $344.2 million, beating guidance, and guided 2026 revenue of $340–350 million (mid-to-high teens growth ex certain assets).
• DecisionDx?Melanoma delivered 39,083 test reports (?9% YoY), reached ~31% patient penetration with nearly 17,000 ordering clinicians and 58 peer?reviewed publications, and Castle is preparing a de novo 510(k) submission (targeting late this year/early next) to help commercial reimbursement under state biomarker laws.
• TissueCypher test volume grew 86% to 39,014 reports in 2025, surpassed 80,000 orders to date, was highlighted in the AGA Barrett’s esophagus guideline, and management sees only ~11% patient penetration today with a long runway for further adoption.
• AdvanceAD?Tx launched in limited access in late Nov 2025 (?150 initial accounts) and generated ?500 orders by mid?Feb; Castle expects immaterial 2026 revenue with material contribution in 2027–2028 and reimbursement updates expected in H2 2026.
• Profitability pressured in 2025: net loss of $24.2 million (vs. prior?year income), adjusted EBITDA fell to $44.0 million, and adjusted gross margin compressed partly due to loss of DecisionDx?SCC revenue and a one?time ~$20.1 million amortization acceleration, while operating expenses increased—offset by a strong cash position of ~$299.5 million.

Castle Biosciences Price Performance

Shares of CSTL traded up $1.05 during mid-day trading on Thursday, hitting $31.88. 665,697 shares of the company were exchanged, compared to its average volume of 416,914. The company has a debt-to-equity ratio of 0.02, a quick ratio of 6.31 and a current ratio of 6.47. Castle Biosciences has a 1-year low of $14.59 and a 1-year high of $44.28. The stock has a market cap of $930.58 million, a price-to-earnings ratio of -70.84 and a beta of 1.06. The company has a 50 day moving average of $37.52 and a 200-day moving average of $31.05.

Castle Biosciences News Roundup

Here are the key news stories impacting Castle Biosciences this week:

• Positive Sentiment: Q4 results beat expectations — EPS loss was smaller than feared and quarterly revenue beat consensus, signaling better near?term operating performance than analysts expected. Castle Biosciences, Inc. (CSTL) Reports Q4 Loss, Beats Revenue Estimates
• Positive Sentiment: Full?year 2025 revenue exceeded guidance at $344M and core test reports (DecisionDx?Melanoma, TissueCypher) grew ~37%, showing demand strength in its diagnostic franchises. Management highlighted product launches (AdvanceAD?Tx) that expand TAM. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Positive Sentiment: 2026 revenue outlook of $340?350M (above consensus ~$335M) gives a clearer top?line target and likely supported the rally despite mixed profitability metrics. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue
• Neutral Sentiment: Company ended 2025 with a strong liquidity position (~$299.5M in cash & marketable securities), which reduces near?term financing risk but doesn’t resolve profitability trends. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Neutral Sentiment: Analyst coverage remains constructive (average “Moderate Buy” / several Buy ratings and $41–$52 price targets), which can amplify positive reaction to beats/guidance. Castle Biosciences, Inc. (NASDAQ:CSTL) Receives Average Rating of “Moderate Buy” from Analysts
• Negative Sentiment: Profitability weakened — 2025 showed a net loss (~$24.2M) and adjusted EBITDA declined materially year?over?year; Q4 still posted a small GAAP loss — a reminder that top?line growth has not fully restored margins. Castle Biosciences Reports Fourth Quarter and Full–Year 2025 Results
• Negative Sentiment: Operational headwinds — Medicare coverage changes and the discontinuation of the IDgenetix test reduced some revenue and required one?time amortization adjustments, which pressured margins. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue
• Negative Sentiment: Significant insider selling activity was reported over the past six months, which can be viewed negatively by the market even if it’s routine liquidity. Castle Biosciences Reports 37% Increase in Core Test Reports for 2025, Achieving $344 Million in Revenue

Insider Activity at Castle Biosciences

In other Castle Biosciences news, insider Derek J. Maetzold sold 817 shares of the stock in a transaction that occurred on Wednesday, February 4th. The stock was sold at an average price of $37.99, for a total transaction of $31,037.83. Following the completion of the transaction, the insider owned 83,698 shares of the company’s stock, valued at $3,179,687.02. This represents a 0.97% decrease in their ownership of the stock. The sale was disclosed in a legal filing with the Securities & Exchange Commission, which is available through this hyperlink. Also, COO Kristen M. Oelschlager sold 14,888 shares of Castle Biosciences stock in a transaction that occurred on Wednesday, December 17th. The stock was sold at an average price of $39.31, for a total value of $585,247.28. Following the completion of the sale, the chief operating officer directly owned 12,323 shares in the company, valued at $484,417.13. This represents a 54.71% decrease in their ownership of the stock. The disclosure for this sale is available in the SEC filing. Over the last quarter, insiders have sold 29,617 shares of company stock valued at $1,167,887. 6.50% of the stock is owned by company insiders.

Institutional Investors Weigh In On Castle Biosciences

A number of hedge funds have recently modified their holdings of CSTL. Amundi boosted its position in Castle Biosciences by 15,811.5% during the first quarter. Amundi now owns 4,137 shares of the company’s stock worth $79,000 after acquiring an additional 4,111 shares during the last quarter. AQR Capital Management LLC lifted its stake in Castle Biosciences by 548.9% in the 1st quarter. AQR Capital Management LLC now owns 137,022 shares of the company’s stock worth $2,743,000 after purchasing an additional 115,907 shares in the last quarter. MIRAE ASSET GLOBAL ETFS HOLDINGS Ltd. boosted its holdings in shares of Castle Biosciences by 4.4% during the 1st quarter. MIRAE ASSET GLOBAL ETFS HOLDINGS Ltd. now owns 15,441 shares of the company’s stock worth $309,000 after purchasing an additional 655 shares during the last quarter. Jones Financial Companies Lllp grew 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 purchasing an additional 2,648 shares in the last quarter. Finally, Legal & General Group Plc grew its position in shares of Castle Biosciences by 34.7% in the second quarter. Legal & General Group Plc now owns 34,908 shares of the company’s stock valued at $713,000 after purchasing an additional 8,992 shares in the last quarter. 92.60% of the stock is currently owned by institutional investors and hedge funds.

Analyst Upgrades and Downgrades

A number of research analysts have issued reports on the company. Canaccord Genuity Group boosted their price target on Castle Biosciences from $37.00 to $50.00 and gave the company a “buy” rating in a report on Monday, December 22nd. Lake Street Capital boosted their target price on shares of Castle Biosciences from $35.00 to $52.00 and gave the company a “buy” rating in a research note on Monday, January 12th. Zacks Research raised shares of Castle Biosciences from a “hold” rating to a “strong-buy” rating in a report on Monday, February 2nd. KeyCorp restated an “overweight” rating and set a $50.00 target price on shares of Castle Biosciences in a research report on Thursday, January 29th. Finally, Guggenheim lifted their price target on Castle Biosciences from $43.00 to $47.00 and gave the company a “buy” rating in a research note on Monday, January 26th. One analyst has rated the stock with a Strong Buy rating, seven have assigned a Buy rating and one has given a Sell rating to the company’s stock. According to MarketBeat.com, the company currently has an average rating of “Moderate Buy” and an average price target of $47.14.

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.