Castle Biosciences Reports Third Quarter 2026 Results

PR Newswire

FRIENDSWOOD, Texas, Nov. 5, 2026

Delivered Q3 2026 revenue of $102.9 million, an increase of 24% over Q3 2025

TissueCypher® test report volume increased 47% over Q3 2025

Raising full-year 2026 revenue guidance to $385-395 million from $365-375 million

Conference call and webcast today at 4:30 p.m. ET

FRIENDSWOOD, Texas, Nov. 5, 2026 /PRNewswire/ -- Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, today announced its financial results for the third quarter and nine months ended September 30, 2026.

Castle Biosciences today announced its financial results for the third quarter and nine months ended Sept. 30, 2026.

"Our team delivered another strong quarter, reflecting consistent execution across our portfolio," said Derek Maetzold, president and chief executive officer of Castle Biosciences. "TissueCypher was a key contributor to our top-line performance, delivering 47% year-over-year growth in test report volume compared to the third quarter of 2025. We generated $19.7 million in net cash provided by operating activities, reflecting our disciplined approach to expense management and operational efficiency while continuing to invest in strategic growth opportunities.

"DecisionDx®-Melanoma continues to serve as the foundation of our dermatologic testing franchise, with 5% year-over-year growth in test report volume through the first nine months of 2026 compared to the same period in 2025. Alongside DecisionDx-Melanoma, AdvanceAD-Tx™ and DecisionDx®-SCC broaden the clinical value of our dermatologic portfolio and position us to support our medium- and long-term growth opportunities, and combined, our dermatology commercial team delivered 15,168 test reports in the third quarter.

"Overall, our third-quarter results reflect the strength of our portfolio, consistent execution and continued progress toward our long-term growth objectives. I want to thank the entire Castle team for their dedication, hard work and unwavering commitment to improving patient care."

Third Quarter Ended Sep. 30, 2026, Financial and Operational Highlights

Core revenue drivers:

Additional tests:

Nine Months Ended Sep. 30, 2026, Financial and Operational Highlights

Core revenue drivers:

Additional tests:

Cash, Cash Equivalents and Marketable Investment Securities

As of Sep. 30, 2026, the Company's cash, cash equivalents and marketable investment securities totaled $277.7 million.

2026 Outlook

Castle Biosciences is raising its guidance for anticipated total revenue in 2026. The Company now anticipates generating between $385-395 million in total revenue in 2026, compared to the previously provided guidance of between $365-375 million. Further, the Company maintains its expectation to achieve positive Adjusted EBITDA for the fourth quarter 2026, the full year 2026 and the full year 2027.

Third Quarter 2026 Highlights

Dermatology - Skin Cancer

Dermatology - Atopic Dermatitis

Gastroenterology

Pipeline Initiatives

Corporate

Conference Call and Webcast Details

Castle Biosciences will hold a conference call on Thursday, November 5, 2026, at 4:30 p.m. Eastern time to discuss its third quarter 2026 results and provide a corporate update.

A live webcast of the conference call can be accessed here: https://event.choruscall.com/mediaframe/webcast.html?webcastid=tHS7IFft or via the webcast link on the Investor Relations page of the Company's website, https://ir.castlebiosciences.com/. Please access the webcast at least 10 minutes before the conference call start time. An archive of the webcast will be available on the Company's website until November 26, 2026.

There will be a brief Question & Answer session following management commentary.

Use of Non-GAAP Financial Measures (UNAUDITED)

In this release, we use the metrics of Adjusted Revenues, Adjusted Gross Margin, Adjusted EBITDA and Adjusted Net (Loss) Income per Share, Basic and Diluted, which are non-GAAP financial measures and are not calculated in accordance with generally accepted accounting principles in the United States (GAAP). Adjusted Revenues and Adjusted Gross Margin reflect adjustments to GAAP net revenues to exclude net positive and/or net negative revenue adjustments recorded in the current period associated with changes in estimated variable consideration related to test reports delivered in previous periods. Adjusted Gross Margin further excludes acquisition-related intangible asset amortization. Adjusted EBITDA excludes from net loss or income: interest income, interest expense, income tax benefit or expense, depreciation and amortization expense, stock-based compensation expense and net losses (gains) on equity securities. Adjusted Net (Loss) Income per Share, Basic and Diluted, excludes a one-time adjustment of an acceleration of amortization expense for our IDgenetix test from net loss.

We use Adjusted Revenues, Adjusted Gross Margin, Adjusted EBITDA and Adjusted Net (Loss) Income per Share, Basic and Diluted, internally because we believe these metrics provide useful supplemental information in assessing our revenue and operating performance reported in accordance with GAAP, respectively. We believe that Adjusted Revenues, when used in conjunction with our test report volume information, facilitates investors' analysis of our current-period revenue performance and average selling price performance by excluding the effects of revenue adjustments related to test reports delivered in prior periods, since these adjustments may not be indicative of the current or future performance of our business. We believe that providing Adjusted Revenues may also help facilitate comparisons to our historical periods. Adjusted Gross Margin is calculated using Adjusted Revenues and therefore excludes the impact of revenue adjustments related to test reports delivered in prior periods, which we believe is useful to investors as described above. We further exclude acquisition-related intangible asset amortization in the calculation of Adjusted Gross Margin. We believe that excluding acquisition-related intangible asset amortization may facilitate gross margin comparisons to historical periods and may be useful in assessing current-period performance without regard to the historical accounting valuations of intangible assets, which are applicable only to tests we acquired rather than internally developed. Adjusted Net (Loss) Income per Share, Basic and Diluted, is calculated by excluding a one-time adjustment of an acceleration of amortization expense for our IDgenetix test from net loss. We believe that providing Adjusted Net (Loss) Income per Share, Basic and Diluted, may also help facilitate comparisons to our historical periods. We believe Adjusted EBITDA may enhance an evaluation of our operating performance because it excludes the impact of prior decisions made about capital investment, financing, investing and certain expenses we believe are not indicative of our ongoing performance. However, these non-GAAP financial measures may be different from non-GAAP financial measures used by other companies, even when the same or similarly titled terms are used to identify such measures, limiting their usefulness for comparative purposes.

These non-GAAP financial measures are not meant to be considered in isolation or used as substitutes for net revenues, gross margin, net loss or net loss per share reported in accordance with GAAP; should be considered in conjunction with our financial information presented in accordance with GAAP; have no standardized meaning prescribed by GAAP; are unaudited; and are not prepared under any comprehensive set of accounting rules or principles. In addition, from time to time in the future, there may be other items that we may exclude for purposes of these non-GAAP financial measures, and we may in the future cease to exclude items that we have historically excluded for purposes of these non-GAAP financial measures. Likewise, we may determine to modify the nature of adjustments to arrive at these non-GAAP financial measures. Because of the non-standardized definitions of non-GAAP financial measures, the non-GAAP financial measure as used by us in this press release and the accompanying reconciliation tables have limits in their usefulness to investors and may be calculated differently from, and therefore may not be directly comparable to, similarly titled measures used by other companies. Accordingly, investors should not place undue reliance on non-GAAP financial measures. Reconciliations of these non-GAAP financial measures to the most directly comparable GAAP financial measures are presented in the tables at the end of this release.

About Castle Biosciences

Castle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving health through innovative tests that guide patient care. With a primary focus in dermatologic and gastroenterological disease, we develop personalized, clinically actionable solutions that help improve disease management and patient outcomes.

We put people first—empowering patients and clinicians and informing care decisions through rigorous science and advanced molecular tests that support more confident treatment planning. To learn more, visit www.CastleBiosciences.com and connect with us on LinkedIn, Instagram, Facebook and X.

DecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC, MyPath Melanoma, AdvanceAD-Tx, TissueCypher, Esopredict, DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences, Inc.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the "safe harbor" created by those sections. These forward-looking statements include, but are not limited to, statements concerning our expectations regarding: Castle's 2026 total revenue guidance of $385-395 million; expectations for achieving positive Adjusted EBITDA for the fourth quarter 2026, the full year 2026 and the full year 2027; continued top-line performance and growth of test volumes; the ability of DecisionDx-Melanoma, DecisionDx-SCC, TissueCypher and AdvanceAD-Tx to bring substantial added value to clinicians and their patients; the ability of DecisionDx-Melanoma to support more informed SLNB decision-making for patients with CM; the ability of TissueCypher to (i) predict a patient's five-year risk of progression from BE and (ii) help clinicians tailor management decisions based on an individual patient's risk profile; the ability of AdvanceAD-Tx to guide systemic treatment decision making in patients with AD; the timing of deliveries and clinical study progress under our collaboration with SciBase; our anticipated growth and the anticipated benefits of our new Scottsdale, Arizona facility; and Castle's ability to achieve near- and long-term success and the continued growth of our portfolio. The words "anticipate," "aims" "believe," "can," "continue," "could," "expect," "goal," "guidance," "may," "plan," "potentially," "providing," "upcoming," "will" and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We may not actually achieve the plans, intentions, or expectations disclosed in our forward-looking statements and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements that we make. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation: our assumptions or expectations regarding reimbursement for our products and subsequent coverage decisions; our estimated total addressable markets for our products and product candidates and the related expenses, capital requirements and potential needs for additional financing; the anticipated cost, timing and success of our product candidates; our plans to research, develop and commercialize new tests; our ability to successfully integrate new businesses, assets, products or technologies acquired through acquisitions; the effects of macroeconomic events and conditions, including inflation and monetary supply shifts, labor shortages, liquidity concerns at, and failures of, banks and other financial institutions or other disruptions in the banking system or financing markets, recession risks, supply chain disruptions, tariffs, outbreaks of contagious diseases and geopolitical events (such as the ongoing conflicts in the Middle East and Ukraine-Russia conflict), among others, on our business and our efforts to address any impact on our business; the possibility that subsequent study or trial results and findings may contradict earlier study or trial results and findings or may not support the results discussed in this press release, including with respect to the tests discussed in this press release; the risk that our collaboration with SciBase, including the portable pen device order and related clinical studies, may be delayed, modified or not completed as anticipated; our planned installation of additional equipment and supporting technology infrastructures and implementation of certain process efficiencies may not enable us to increase the future scalability of our TissueCypher Test; the possibility that actual application of our tests may not provide the aforementioned benefits to patients; the possibility that our newer gastroenterology franchise may not contribute to the achievement of our long-term financial targets as anticipated; the risk that our new Scottsdale, Arizona facility may not provide the anticipated capacity, infrastructure or growth benefits; and the risks set forth under the heading "Risk Factors" in our Annual Report on Form 10-K for the year ended December 31, 2025 and our Quarterly Reports on Form 10-Q for the quarters ended March 31, 2026, June 30, 2026 and September 30, 2026, each filed or to be filed with the SEC, and in our other filings with the SEC. The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements, except as may be required by law.

Investor Relations Contact:
Camilla Zuckero
czuckero@castlebiosciences.com
281-906-3868

Media Contact:
Allison Marshall
amarshall@castlebiosciences.com

CASTLE BIOSCIENCES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS

(UNAUDITED)

(in thousands, except per share data)



Three Months Ended
September 30,


Nine Months Ended
September 30,


2026


2025


2026


2025

NET REVENUES

$     102,891


$      83,043


$     290,116


$     257,219

OPERATING EXPENSES








Cost of sales (exclusive of amortization of acquired intangible assets)

23,919


18,704


68,152


52,713

Research and development

15,807


12,960


44,778


38,335

Selling, general and administrative

63,792


55,907


194,813


172,592

Amortization of acquired intangible assets

2,104


2,276


6,581


32,562

Total operating expenses, net

105,622


89,847


314,324


296,202

Operating loss

(2,731)


(6,804)


(24,208)


(38,983)

Interest income

2,512


2,833


7,413


8,876

Net (losses) gains on equity securities

(3,425)


3,561


(2,033)


3,321

Interest expense

(197)


(24)


(524)


(62)

Other income (expense)

39


48


(553)


48

Loss before income taxes

(3,802)


(386)


(19,905)


(26,800)

Income tax expense (benefit)

298


115


777


(4,974)

Net loss

$       (4,100)


$         (501)


$     (20,682)


$     (21,826)









Loss per share:








Basic

$        (0.13)


$        (0.02)


$        (0.69)


$        (0.76)

Diluted

$        (0.13)


$        (0.02)


$        (0.69)


$        (0.76)









Weighted-average shares outstanding:








Basic

30,633


29,073


30,112


28,868

Diluted

30,633


29,073


30,112


28,868

Stock-Based Compensation Expense

Stock-based compensation expense is included in the unaudited condensed consolidated statements of operations as follows (in thousands):


Three Months Ended
September 30,


Nine Months Ended
September 30,


2026


2025


2026


2025

Cost of sales (exclusive of amortization of acquired intangible assets)

$        1,403


$        1,446


$        4,080


$        4,324

Research and development

1,611


1,950


4,732


5,807

Selling, general and administrative

8,218


8,704


23,785


24,356

Total stock-based compensation expense

$      11,232


$      12,100


$      32,597


$      34,487

 

CASTLE BIOSCIENCES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS

(UNAUDITED)

(in thousands)



Three Months Ended
September 30,


Nine Months Ended
September 30,


2026


2025


2026


2025

Net loss

$       (4,100)


$         (501)


$     (20,682)


$     (21,826)

Other comprehensive loss:








Net unrealized (loss) gain on marketable investment securities

(236)


201


(759)


10

Comprehensive loss

$       (4,336)


$         (300)


$     (21,441)


$     (21,816)

 

CASTLE BIOSCIENCES, INC.

CONDENSED CONSOLIDATED BALANCE SHEETS

(in thousands)



September 30, 2026


December 31, 2025

ASSETS

(unaudited)



Current Assets




Cash and cash equivalents

$       77,994


$      116,729

Marketable investment securities

199,671


182,776

Accounts receivable, net

52,101


43,382

Inventory

10,381


10,254

Prepaid expenses and other current assets

16,710


7,956

Total current assets

356,857


361,097

Long-term accounts receivable, net

1,264


1,878

Property and equipment, net

111,461


97,443

Operating lease assets

13,970


14,795

Goodwill and other intangible assets, net

91,492


99,574

Other assets – long-term

4,364


3,769

Total assets

$      579,408


$      578,556





LIABILITIES AND STOCKHOLDERS' EQUITY




Current Liabilities




Accounts payable

$        13,225


$        18,711

Accrued compensation

33,399


38,287

Contingent consideration

—


1,000

Operating lease liabilities

1,644


1,325

Current portion of long-term debt

4,167


417

Other accrued and current liabilities

15,177


8,937

Total current liabilities

67,612


68,677

Long-term debt

5,917


9,640

Noncurrent portion of contingent consideration

—


1,500

Noncurrent operating lease liabilities

24,609


25,217

Noncurrent finance lease liabilities

237


314

Deferred tax liability

2,398


2,335

Other liabilities

191


—

Total liabilities

100,964


107,683

Stockholders' Equity




Preferred stock

—


—

Common stock

31


30

Additional paid-in capital

723,871


694,860

Accumulated deficit

(244,966)


(224,284)

Accumulated other comprehensive (loss) income

(492)


267

Total stockholders' equity

478,444


470,873

Total liabilities and stockholders' equity

$      579,408


$      578,556

 

CASTLE BIOSCIENCES, INC.

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(UNAUDITED)

(in thousands)



Nine Months Ended

September 30,


2026


2025

OPERATING ACTIVITIES




Net loss

$      (20,682)


$      (21,826)

Adjustments to reconcile net loss to net cash provided by operating activities:




Depreciation and amortization

12,178


36,994

Stock-based compensation expense

32,597


34,487

Net losses (gains) on equity securities

2,033


(3,321)

Deferred income taxes

63


(5,321)

Accretion of discounts on marketable investment securities

(1,190)


(3,511)

Other

906


282

Change in operating assets and liabilities:




Accounts receivable

(8,105)


604

Prepaid expenses and other current assets

(8,838)


(4,535)

Inventory

(127)


(538)

Operating lease assets

873


1,016

Other assets

(768)


(54)

Accounts payable

2,279


3,095

Operating lease liabilities

(337)


(1,066)

Accrued compensation

(4,888)


(792)

Other accrued and current liabilities

6,628


1,902

Other liabilities

191


—

Net cash provided by operating activities

12,813


37,416





INVESTING ACTIVITIES




Purchases of marketable investment securities

(165,567)


(151,306)

Proceeds from maturities of marketable investment securities

138,800


135,200

Proceeds from maturities of debt securities classified as held-to-maturity

5,600


—

Purchases of debt securities classified as held-to-maturity

—


(5,569)

Proceeds from sale of equity securities

3,248


—

Asset acquisition, net of cash and cash equivalents acquired

—


(18,726)

Purchases of property and equipment

(28,597)


(28,837)

Proceeds from sale of property and equipment

21


40

Net cash used in investing activities

(46,495)


(69,198)





FINANCING ACTIVITIES




Proceeds from exercise of common stock options

1,405


114

Payment of employees' taxes on vested restricted stock units and performance-based restricted stock units

(8,314)


(4,289)

Proceeds from contributions to the employee stock purchase plan

2,930


1,702

Payment of contingent consideration

(1,000)


—

Repayment of principal portion of finance lease liabilities

(74)


(88)

Proceeds from lease incentives received

—


190

Net cash used in financing activities

(5,053)


(2,371)





NET CHANGE IN CASH AND CASH EQUIVALENTS

(38,735)


(34,153)

Beginning of period

116,729


119,709

End of period

$       77,994


$       85,556

CASTLE BIOSCIENCES, INC.
Reconciliation of Non-GAAP Financial Measures (UNAUDITED)

The table below presents the reconciliation of Adjusted Revenues, Adjusted Gross Margin and Adjusted Net Loss Per Share, Basic and Diluted, which are non-GAAP financial measures. See "Use of Non-GAAP Financial Measures (UNAUDITED)" above for further information regarding the Company's use of non-GAAP financial measures.


Three Months Ended
September 30,


Nine Months Ended
September 30,

(in thousands, except per share data)

2026


2025


2026


2025

Adjusted Revenues








Net revenues (GAAP)

$ 102,891


$   83,043


$ 290,116


$ 257,219

Revenue associated with test reports delivered in prior periods

(944)


(2,498)


3,549


5,436

Adjusted Revenues (Non-GAAP)

$ 101,947


$   80,545


$ 293,665


$ 262,655









Adjusted Gross Margin








Gross margin (GAAP)1

$   76,868


$   62,063


$ 215,383


$ 171,944

Amortization of acquired intangible assets

2,104


2,276


6,581


32,562

Revenue associated with test reports delivered in prior periods

(944)


(2,498)


3,549


5,436

Adjusted Gross Margin (Non-GAAP)

$   78,028


$   61,841


$ 225,513


$ 209,942









Gross Margin percentage (GAAP)2

74.7 %


74.7 %


74.2 %


66.8 %

Adjusted Gross Margin percentage (Non-GAAP)3

76.5 %


76.8 %


76.8 %


79.9 %









Adjusted Net Loss Per Share, Basic and Diluted








Net loss (GAAP)

$  (4,100)


$     (501)


$ (20,682)


$ (21,826)

Amortization of acquired intangible assets4

—


—


—


20,099

Adjusted Net Loss (Non-GAAP)

$  (4,100)


$     (501)


$ (20,682)


$  (1,727)









Weighted-average shares outstanding:








Basic

30,633


29,073


30,112


28,868

Diluted

30,633


29,073


30,112


28,868

Net loss per share (GAAP)5








Basic

$    (0.13)


$    (0.02)


$    (0.69)


$    (0.76)

Diluted

$    (0.13)


$    (0.02)


$    (0.69)


$    (0.76)

Adjusted Net Loss Per Share (Non-GAAP)6








Basic

$    (0.13)


$    (0.02)


$    (0.69)


$    (0.06)

Diluted

$    (0.13)


$    (0.02)


$    (0.69)


$    (0.06)








1.

 Calculated as net revenues (GAAP) less the sum of cost of sales (exclusive of amortization of acquired intangible assets) and amortization of acquired intangible assets.

2.

 Calculated as gross margin (GAAP) divided by net revenues (GAAP).

3.

 Calculated as Adjusted Gross Margin (Non-GAAP) divided by Adjusted Revenues (Non-GAAP).

4.

 Represents a one-time adjustment of an acceleration of amortization expense for our IDgenetix test during the three months ended March 31, 2025.

5.

 Calculated as net loss (GAAP) divided by weighted-average shares outstanding, basic and diluted.

6.

 Calculated as Adjusted Net Loss (Non-GAAP) divided by weighted-average shares outstanding, basic and diluted.

The table below presents the reconciliation of Adjusted EBITDA, which is a non-GAAP financial measure. See "Use of Non-GAAP Financial Measures (UNAUDITED)" above for further information regarding the Company's use of non-GAAP financial measures.


Three Months Ended
September 30,


Nine Months Ended
September 30,

(in thousands)

2026


2025


2026


2025

Adjusted EBITDA








Net loss

$    (4,100)


$      (501)


$  (20,682)


$  (21,826)

Interest income

(2,512)


(2,833)


(7,413)


(8,876)

Interest expense

197


24


524


62

Income tax expense (benefit)

298


115


777


(4,974)

Depreciation and amortization

4,179


3,816


12,178


36,994

Stock-based compensation expense

11,232


12,100


32,597


34,487

Net losses (gains) on equity securities

3,425


(3,561)


2,033


(3,321)

Adjusted EBITDA (Non-GAAP)

$    12,719


$     9,160


$    20,014


$    32,546

 

Castle Biosciences

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SOURCE Castle Biosciences, Inc.