Castle Biosciences (NASDAQ:CSTL) Announces Quarterly Earnings Results, Beats Estimates By $0.13 EPS

Castle Biosciences (NASDAQ:CSTL) issued its quarterly earnings data on Thursday. The company reported ($0.08) earnings per share (EPS) for the quarter, topping the consensus estimate of ($0.21) by $0.13, FiscalAI reports. The firm 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

CSTL stock traded up $1.05 during trading on Thursday, hitting $31.88. The stock had a trading volume of 665,697 shares, compared to its average volume of 416,914. The company’s 50 day moving average price is $37.52 and its two-hundred day moving average price is $31.05. 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 debt-to-equity ratio of 0.02, a quick ratio of 6.31 and a current ratio of 6.47.

Analyst Upgrades and Downgrades

CSTL has been the subject of several research reports. KeyCorp reaffirmed an “overweight” rating and set a $50.00 price target on shares of Castle Biosciences in a research note on Thursday, January 29th. Weiss Ratings reissued a “sell (d)” rating on shares of Castle Biosciences in a research note on Monday, December 29th. Canaccord Genuity Group lifted their target price on shares of Castle Biosciences from $37.00 to $50.00 and gave the stock a “buy” rating in a research report on Monday, December 22nd. Robert W. Baird upped their price target on shares of Castle Biosciences from $39.00 to $41.00 and gave the company an “outperform” rating in a report on Tuesday, November 4th. Finally, Guggenheim increased their price target on shares of Castle Biosciences from $43.00 to $47.00 and gave the company a “buy” rating in a research report on Monday, January 26th. One investment analyst has rated the stock with a Strong Buy rating, seven have assigned a Buy rating and one has issued a Sell rating to the company’s stock. According to data from MarketBeat, the company has a consensus rating of “Moderate Buy” and an average price target of $47.14.

Insider Transactions at Castle Biosciences

In related news, COO Kristen M. Oelschlager sold 14,888 shares of the firm’s stock in a transaction that occurred on Wednesday, December 17th. The shares were sold at an average price of $39.31, for a total transaction of $585,247.28. Following the sale, the chief operating officer owned 12,323 shares in the company, valued at approximately $484,417.13. This trade represents a 54.71% 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 817 shares of the business’s stock in a transaction on Wednesday, February 4th. The shares were sold at an average price of $37.99, for a total value 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 trade represents a 0.97% 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. Insiders own 6.50% of the company’s stock.

Institutional Investors Weigh In On Castle Biosciences

Hedge funds and other institutional investors have recently made changes to their positions in the business. RTW Investments LP acquired a new stake in Castle Biosciences in the 4th quarter worth about $82,283,000. Dimensional Fund Advisors LP increased its stake in shares of Castle Biosciences by 7.0% during the 3rd quarter. Dimensional Fund Advisors LP now owns 1,474,089 shares of the company’s stock valued at $33,564,000 after acquiring an additional 96,084 shares during the last quarter. Wasatch Advisors LP lifted its holdings in shares of Castle Biosciences by 5.1% during the 2nd quarter. Wasatch Advisors LP now owns 1,049,773 shares of the company’s stock worth $21,436,000 after acquiring an additional 51,318 shares during the period. State Street Corp boosted its position in shares of Castle Biosciences by 1.7% in the fourth quarter. State Street Corp now owns 736,454 shares of the company’s stock worth $28,648,000 after acquiring an additional 12,374 shares during the last quarter. Finally, Geode Capital Management LLC boosted its position in shares of Castle Biosciences by 2.3% in the fourth quarter. Geode Capital Management LLC now owns 714,913 shares of the company’s stock worth $27,815,000 after acquiring an additional 16,303 shares during the last quarter. Hedge funds and other institutional investors own 92.60% of the company’s stock.

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.