Castle Biosciences (NASDAQ:CSTL) Announces Earnings Results, Hits Estimates

Castle Biosciences (NASDAQ:CSTL) posted its quarterly earnings data on Wednesday. The company reported ($0.49) earnings per share for the quarter, meeting analysts’ consensus estimates of ($0.49), FiscalAI reports. Castle Biosciences had a negative net margin of 7.02% and a negative return on equity of 0.89%. The firm had revenue of $84.23 million for the quarter, compared to analyst estimates 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 Price Performance

Shares of NASDAQ CSTL traded down $3.00 during trading on Thursday, hitting $21.76. 328,854 shares of the company were exchanged, compared to its average volume of 374,851. The company has a market cap of $659.18 million, a price-to-earnings ratio of -25.96 and a beta of 1.11. Castle Biosciences has a 1 year low of $14.59 and a 1 year high of $44.28. The firm’s fifty day moving average price is $25.62 and its 200 day moving average price 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.

Trending Headlines about Castle Biosciences

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

• Positive Sentiment: Q1 revenue topped expectations and core test reports (DecisionDx‑Melanoma, TissueCypher) grew ~36% year-over-year, signaling demand strength in the company’s diagnostic business. Read More.
• Positive Sentiment: Management raised full‑year 2026 revenue guidance to $345–$355 million (from $340–$350M), a modest upward revision that supports revenue growth expectations. Read More.
• Positive Sentiment: Wall‑street analysts remain constructive: the consensus price‑target mean implies substantial upside and several analyst notes highlight upside potential. This analyst optimism can support medium‑term investor sentiment. Read More.
• Positive Sentiment: Robert W. Baird kept an Outperform rating on CSTL despite a very small trim to its price target (from $44 to $43), signaling continued analyst conviction. Read More.
• Neutral Sentiment: Q1 EPS was a ($0.49) loss, which matched Street expectations — a beat versus the deeper loss some models forecast — so the result was neither a clear positive nor negative surprise. Read More.
• Neutral Sentiment: The full Q1 earnings call transcript is available for investors who want management’s commentary on margins, test mix and the guide. Read More.
• Negative Sentiment: Castle remains unprofitable on a GAAP basis (negative net margin and a wider loss versus a year ago), which keeps valuation and near‑term upside tethered to sustained revenue growth and margin improvement. That lingering loss profile likely contributes to downward pressure on the stock. Read More.

Insider Activity at Castle Biosciences

In other news, Director G Bradley Cole sold 7,403 shares of Castle Biosciences stock in a transaction 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 owned 19,309 shares of the company’s stock, valued at $549,727.23. The trade was a 27.71% decrease in their position. The transaction was disclosed in a filing with the SEC, which is available through this hyperlink. Also, insider Derek J. Maetzold sold 3,622 shares of Castle Biosciences stock in a transaction 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 transaction, the insider directly owned 2,502 shares of the company’s stock, valued at $62,800.20. This trade represents a 59.14% decrease in their position. Additional details regarding this sale are available in the official SEC disclosure. The transaction was executed under a pre-arranged Rule 10b5-1 trading plan. Insiders have sold a total of 74,575 shares of company stock valued at $1,948,344 over the last 90 days. Company insiders own 6.10% of the company’s stock.

Institutional Inflows and Outflows

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

Analysts Set New Price Targets

A number of research firms recently weighed in on CSTL. Zacks Research upgraded shares of Castle Biosciences from a “hold” rating to a “strong-buy” rating in a research report on Monday, April 27th. KeyCorp reiterated an “overweight” rating and issued a $50.00 price objective on shares of Castle Biosciences in a research report on Thursday, January 29th. Lake Street Capital lifted their price objective on shares of Castle Biosciences from $35.00 to $52.00 and gave the company a “buy” rating in a research report on Monday, January 12th. Guggenheim lifted their price objective 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. Finally, Canaccord Genuity Group lowered their price objective on shares of Castle Biosciences from $50.00 to $40.00 and set a “buy” rating on the stock in a research report on Monday, April 20th. One equities research analyst has rated the stock with a Strong Buy rating, eight have issued a Buy rating and one has issued a Sell rating to the company. According to data from MarketBeat.com, the stock 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.