Castle Biosciences (NASDAQ:CSTL) Announces Quarterly Earnings Results

Castle Biosciences (NASDAQ:CSTL) 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 2.76% and a negative net margin of 3.78%.The company had revenue of $84.23 million for the quarter, compared to analysts’ expectations 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 Down 0.4%

Shares of NASDAQ CSTL traded down $0.08 during mid-day trading on Friday, hitting $19.17. 116,963 shares of the stock traded hands, compared to its average volume of 391,759. The company has a market cap of $580.70 million, a price-to-earnings ratio of -43.54 and a beta of 1.11. The stock has a fifty day moving average price of $25.41 and a 200-day moving average price of $32.15. Castle Biosciences has a 52 week low of $14.59 and a 52 week high of $44.28. The company has a debt-to-equity ratio of 0.02, a quick ratio of 5.11 and a current ratio of 5.26.

Insider Buying and Selling at Castle Biosciences

In other news, insider Derek J. Maetzold sold 3,622 shares of the business’s stock in a transaction that occurred on Tuesday, April 21st. The stock was sold at an average price of $25.10, for a total value of $90,912.20. Following the sale, the insider directly owned 2,502 shares of the company’s stock, valued at $62,800.20. The trade was a 59.14% decrease in their position. The sale was disclosed in a document filed with the SEC, which is available through the SEC website. The transaction was executed under a pre-arranged Rule 10b5-1 trading plan. Also, CFO Frank Stokes sold 6,001 shares of the firm’s stock in a transaction that occurred on Thursday, March 5th. The shares were sold at an average price of $27.98, for a total value of $167,907.98. Following the transaction, the chief financial officer directly owned 60,085 shares of the company’s stock, valued at approximately $1,681,178.30. This trade represents a 9.08% decrease in their position. The disclosure for this sale is available in the SEC filing. In the last quarter, insiders have sold 74,575 shares of company stock worth $1,948,344. Corporate insiders own 6.10% of the company’s stock.

Institutional Investors Weigh In On Castle Biosciences

Institutional investors have recently made changes to their positions in the company. RTW Investments LP bought a new position in Castle Biosciences in the 4th quarter valued at approximately $82,283,000. Summit Partners Public Asset Management LLC bought a new position in shares of Castle Biosciences during the third quarter valued at $9,108,000. Wellington Management Group LLP bought a new stake in Castle Biosciences in the 4th quarter worth about $8,502,000. Millennium Management LLC raised its position in Castle Biosciences by 34.2% in the 3rd quarter. Millennium Management LLC now owns 575,089 shares of the company’s stock worth $13,095,000 after buying an additional 146,692 shares during the last quarter. Finally, Bridgeway Capital Management LLC lifted its position in Castle Biosciences by 334.8% during the third quarter. Bridgeway Capital Management LLC now owns 177,180 shares of the company’s stock valued at $4,034,000 after purchasing an additional 136,430 shares during the period. Hedge funds and other institutional investors own 92.60% of the company’s stock.

Analyst Ratings Changes

A number of research analysts have recently commented on CSTL shares. Lake Street Capital upped their price target on Castle Biosciences from $35.00 to $52.00 and gave the company a “buy” rating in a research report on Monday, January 12th. Morgan Stanley upgraded Castle Biosciences to a “buy” rating in a research note on Monday, March 2nd. KeyCorp reissued an “overweight” rating and issued a $50.00 price target on shares of Castle Biosciences in a report on Thursday, January 29th. Canaccord Genuity Group lowered their price objective on Castle Biosciences from $50.00 to $40.00 and set a “buy” rating on the stock in a research report on Monday, April 20th. Finally, Guggenheim boosted their price objective on Castle Biosciences from $43.00 to $47.00 and gave the stock a “buy” rating in a report on Monday, January 26th. One equities research analyst has rated the stock with a Strong Buy rating, eight have given a Buy rating and one has given a Sell rating to the company. According to data from MarketBeat.com, the stock currently has a consensus rating of “Moderate Buy” and an average price target of $46.00.

Castle Biosciences Company Profile

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.