Castle Biosciences (NASDAQ:CSTL) Announces Earnings Results

Castle Biosciences (NASDAQ:CSTL) released its earnings results on Wednesday. The company reported ($0.49) earnings per share (EPS) for the quarter, meeting analysts’ consensus estimates of ($0.49), FiscalAI reports. Castle Biosciences had a negative return on equity of 0.89% and a negative net margin of 7.02%.The firm 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 Trading Up 0.6%

Shares of CSTL stock traded up $0.15 during mid-day trading on Wednesday, reaching $24.75. 701,819 shares of the stock traded hands, compared to its average volume of 295,398. The stock’s fifty day simple moving average is $25.62 and its two-hundred day simple moving average is $32.17. Castle Biosciences has a 1-year low of $14.59 and a 1-year high of $44.28. The company has a market cap of $749.93 million, a price-to-earnings ratio of -29.12 and a beta of 1.11. The company has a quick ratio of 5.11, a current ratio of 5.26 and a debt-to-equity ratio of 0.02.

Analysts Set New Price Targets

A number of research firms have issued reports on CSTL. Zacks Research upgraded Castle Biosciences from a “hold” rating to a “strong-buy” rating in a research report on Monday, April 27th. Lake Street Capital lifted their target price on 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 target price on Castle Biosciences from $43.00 to $47.00 and gave the company a “buy” rating in a research report on Monday, January 26th. Canaccord Genuity Group decreased their target price 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, Morgan Stanley upgraded Castle Biosciences to a “buy” rating in a research report on Monday, March 2nd. One investment analyst has rated the stock with a Strong Buy rating, eight have assigned a Buy rating and one has assigned a Sell rating to the company. According to data from MarketBeat.com, the stock presently has an average rating of “Moderate Buy” and a consensus price target of $46.14.

Insider Transactions at Castle Biosciences

In other news, Director G Bradley Cole sold 7,403 shares of Castle Biosciences stock in a transaction dated Thursday, March 5th. The stock was sold at an average price of $28.47, for a total transaction of $210,763.41. Following the sale, the director directly owned 19,309 shares of the company’s stock, valued at approximately $549,727.23. This trade represents a 27.71% decrease in their ownership of the stock. The sale was disclosed in a document filed with the SEC, which can be accessed through the SEC website. Also, CFO Frank Stokes sold 6,001 shares of Castle Biosciences stock in a transaction dated Thursday, March 5th. The shares were sold at an average price of $27.98, for a total value of $167,907.98. Following the sale, the chief financial officer directly owned 60,085 shares in the company, valued at $1,681,178.30. The trade was a 9.08% decrease in their ownership of the stock. Additional details regarding this sale are available in the official SEC disclosure. Over the last ninety days, insiders sold 74,575 shares of company stock valued at $1,948,344. Company insiders own 6.10% of the company’s stock.

Institutional Trading of Castle Biosciences

A number of hedge funds have recently made changes to their positions in CSTL. RTW Investments LP bought a new stake in Castle Biosciences in the fourth quarter valued at approximately $82,283,000. Summit Partners Public Asset Management LLC bought a new stake in Castle Biosciences in the third quarter valued at approximately $9,108,000. Wellington Management Group LLP bought a new stake in Castle Biosciences in the fourth quarter valued at approximately $8,502,000. Millennium Management LLC boosted its holdings in Castle Biosciences by 34.2% in the third quarter. Millennium Management LLC now owns 575,089 shares of the company’s stock valued at $13,095,000 after acquiring an additional 146,692 shares during the last quarter. Finally, Bridgeway Capital Management LLC boosted its holdings in Castle Biosciences by 334.8% in the third quarter. Bridgeway Capital Management LLC now owns 177,180 shares of the company’s stock valued at $4,034,000 after acquiring an additional 136,430 shares during the last quarter. 92.60% of the stock is owned by institutional investors and hedge funds.

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.