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Castle Biosciences Reports First Quarter 2025 Results

Q1 2025 revenue increased 21% over Q1 2024 to $88 million

Q1 2025 total test reports for our core revenue drivers (DecisionDx®-Melanoma, DecisionDx®-SCC, TissueCypher®) increased 33% over Q1 2024

Raising full-year 2025 revenue guidance to $287-297 million from $280-295 million

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

FRIENDSWOOD, Texas, May 05, 2025 (GLOBE NEWSWIRE) — Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, today announced its financial results for the first quarter ended March 31, 2025.

“We are pleased with the exceptional start to the year, marked by continued growth in test report volume and revenue in the first quarter,” said Derek Maetzold, president and chief executive officer of Castle Biosciences. “We believe our ongoing success reflects both the high clinical value that our clinicians receive from our tests coupled with consistent execution and teamwork across our therapeutic areas.

“We saw strong overall growth in our core revenue drivers. And in this month of May, Skin Cancer Awareness Month, I’m especially pleased DecisionDx-Melanoma recently achieved a significant milestone, surpassing 200,000 test orders since the launch of the test. This milestone is certainly expected, given the highly compelling data demonstrating DecisionDx-Melanoma is shown to be associated with improved patient survival, and I am extremely proud of the entire Castle team. We are grateful to the clinicians and patients who achieved this milestone with us.

“We believe our first-quarter results demonstrate our leadership across our proprietary, first-to-market test portfolio and unwavering commitment to impacting patient outcomes. Looking ahead, as we continue to drive forward our growth initiatives, we are raising our 2025 total revenue guidance to $287-297 million, compared to the previous guidance of $280-295 million.”

First Quarter Ended March 31, 2025, Financial and Operational Highlights

Cash, Cash Equivalents and Marketable Investment Securities

As of March 31, 2025, the Company’s cash, cash equivalents and marketable investment securities totaled $275.2 million.

2025 Outlook
Castle Biosciences is raising its guidance for anticipated total revenue in 2025. The Company now anticipates generating between $287-297 million in total revenue in 2025, compared to the previously provided guidance of between $280-295 million.

First Quarter and Recent Accomplishments and Highlights

Dermatology

Gastroenterology

Mental Health

Corporate

Conference Call and Webcast Details

Castle Biosciences will hold a conference call on Monday, May 5, 2025, at 4:30 p.m. Eastern time to discuss its first quarter 2025 results and provide a corporate update.

A live webcast of the conference call can be accessed here: https://events.q4inc.com/attendee/787806709
or via the webcast link on the Investor Relations page of the Company’s website,
https://ir.castlebiosciences.com/overview/default.aspx. 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 May 26, 2025.

To access the live conference call via phone, please dial 833 470 1428 from the United States, or +1 404 975 4839 internationally, at least 10 minutes prior to the start of the call, using the conference ID 040892.

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 per Share, 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 income (loss): interest income, interest expense, income tax expense (benefit), depreciation and amortization expense, stock-based compensation expense and changes in fair value of trading securities. Adjusted Net Loss 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 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 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 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 income (loss) or net income (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. The Company aims to transform disease management by keeping people first: patients, clinicians, employees and investors.

Castle’s current portfolio consists of tests for skin cancers, Barrett’s esophagus, mental health conditions and uveal melanoma. Additionally, the Company has active research and development programs for tests in these and other diseases with high clinical need, including its test in development to help guide systemic therapy selection for patients with moderate-to-severe atopic dermatitis seeking biologic treatment. To learn more, please visit www.CastleBiosciences.com and connect with us on LinkedIn, Facebook, X and Instagram.

DecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC, MyPath Melanoma, DiffDx-Melanoma, TissueCypher, IDgenetix, 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: our 2025 total revenue guidance of $287-297 million; continued growth of test volumes; the ability of DecisionDx-Melanoma and DecisionDx-SCC to bring substantial added value to clinicians and their patients; the significant impact of DecisionDx-Melanoma on SLNB decision-making for patients with melanoma; DecisionDx-Melanoma’s ability to (i) guide adjuvant therapy, (ii) be a significant predictor of both melanoma-specific and overall mortality and (iii) identify patients at greater predicted risk than indicated by AJCC8 staging alone who may benefit from enhanced surveillance and management to improve outcomes; the ability of DecisionDx-SCC to (i) integrate with BWH staging to improve prognostic accuracy, (ii) significantly refine individual patient risk assessment when used with established staging methods, (iii) enable more personalized treatment decisions and (iv) predict metastatic risk and help guide personalized, risk-aligned treatment decisions; Castle’s ability to achieve near- and long-term success and the continued growth of our portfolio; and Castle’s ability to acquire Previse on the anticipated terms or timeline, if at all. The words “anticipate,” “can,” “could,” “expect,” “goal,” “may,” “plan” 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 continued reimbursement for our DecisionDx-SCC test at the current rate and reimbursement for our other 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, and our plans to research, develop and commercialize new tests and 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 and recession risks, supply chain disruptions, tariffs, outbreaks of contagious diseases and geopolitical events (such as the ongoing Israel-Hamas War and Ukraine-Russia conflict), among others, on our business and our efforts to address its 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; 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 and mental health franchises may not contribute to the achievement of our long-term financial targets as anticipated; and the risks set forth under the heading “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2024 and our Quarterly Report on Form 10-Q for the quarter ended March 31, 2025, 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
March 31,
  2025   2024
NET REVENUES $ 87,988     $ 72,974  
OPERATING EXPENSES      
Cost of sales (exclusive of amortization of acquired intangible assets)   16,383       13,894  
Research and development   12,588       13,809  
Selling, general and administrative   58,620       48,495  
Amortization of acquired intangible assets   28,325       2,247  
Total operating expenses, net   115,916       78,445  
Operating loss   (27,928 )     (5,471 )
Interest income   3,099       2,996  
Changes in fair value of trading securities   (1,425 )      
Interest expense   (17 )     (14 )
Loss before income taxes   (26,271 )     (2,489 )
Income tax (benefit) expense   (423 )     45  
Net loss $ (25,848 )   $ (2,534 )
       
Loss per share, basic and diluted $ (0.90 )   $ (0.09 )
       
Weighted-average shares outstanding, basic and diluted:   28,609       27,485  
               

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
March 31,
  2025
  2024
Cost of sales (exclusive of amortization of acquired intangible assets) $ 1,456     $ 1,314  
Research and development   1,895       2,629  
Selling, general and administrative   7,828       8,732  
Total stock-based compensation expense $ 11,179     $ 12,675  
               
CASTLE BIOSCIENCES, INC.
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE LOSS
(UNAUDITED)
(in thousands)
   
  Three Months Ended
March 31,
  2025   2024
Net loss $         (25,848 )   $         (2,534 )
Other comprehensive loss:      
Net unrealized loss on marketable investment securities           (99 )             (247 )
Comprehensive loss $         (25,947 )   $         (2,781 )
               
CASTLE BIOSCIENCES, INC.
CONDENSED CONSOLIDATED BALANCE SHEETS
(in thousands)
   
  March 31, 2025   December 31, 2024
ASSETS (unaudited)    
Current Assets      
Cash and cash equivalents $ 89,689     $ 119,709  
Marketable investment securities   185,462       173,421  
Accounts receivable, net   56,353       51,218  
Inventory   6,849       8,135  
Prepaid expenses and other current assets   11,035       7,671  
Total current assets   349,388       360,154  
Long-term marketable investment securities   5,570        
Long-term accounts receivable, net   1,000       918  
Property and equipment, net   55,423       51,122  
Operating lease assets   11,164       11,584  
Goodwill and other intangible assets, net   77,904       106,229  
Other assets – long-term   1,266       1,228  
Total assets $ 501,715     $ 531,235  
       
LIABILITIES AND STOCKHOLDERS’ EQUITY      
Current Liabilities      
Accounts payable $ 8,502     $ 6,901  
Accrued compensation   17,857       32,555  
Operating lease liabilities   1,435       1,665  
Current portion of long-term debt   1,111       278  
Other accrued and current liabilities   8,369       7,993  
Total current liabilities   37,274       49,392  
Long-term debt   8,921       9,745  
Noncurrent operating lease liabilities   14,049       14,345  
Noncurrent finance lease liabilities   328       311  
Deferred tax liability   837       1,607  
Total liabilities   61,409       75,400  
Stockholders’ Equity      
Preferred stock          
Common stock   29       28  
Additional paid-in capital   666,120       655,703  
Accumulated deficit   (225,974 )     (200,126 )
Accumulated other comprehensive income   131       230  
Total stockholders’ equity   440,306       455,835  
Total liabilities and stockholders’ equity $ 501,715     $ 531,235  
       
CASTLE BIOSCIENCES, INC.
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(UNAUDITED)
(in thousands)
   
  Three Months Ended
March 31,
  2025   2024
OPERATING ACTIVITIES      
Net loss $ (25,848 )   $ (2,534 )
Adjustments to reconcile net loss to net cash used in operating activities:      
Depreciation and amortization   29,764       3,340  
Stock-based compensation expense   11,179       12,675  
Change in fair value of trading securities   1,425        
Deferred income taxes   (770 )      
Accretion of discounts on marketable investment securities   (1,435 )     (1,699 )
Other   30       179  
Change in operating assets and liabilities:      
Accounts receivable   (5,217 )     (4,262 )
Prepaid expenses and other current assets   (3,364 )     (103 )
Inventory   1,286       297  
Operating lease assets   420       338  
Other assets   (38 )     (230 )
Accounts payable   615       (422 )
Operating lease liabilities   (526 )     (250 )
Accrued compensation   (14,698 )     (14,237 )
Other accrued and current liabilities   1,141       73  
Net cash used in operating activities   (6,036 )     (6,835 )
       
INVESTING ACTIVITIES      
Purchases of marketable investment securities   (48,431 )     (60,754 )
Proceeds from maturities of marketable investment securities   36,300       50,200  
Purchases of debt securities classified as held-to-maturity   (5,569 )      
Purchases of property and equipment   (4,740 )     (9,152 )
Proceeds from sale of property and equipment   9       5  
Net cash used in investing activities   (22,431 )     (19,701 )
       
FINANCING ACTIVITIES      
Proceeds from exercise of common stock options   18       65  
Payment of employees’ taxes on vested restricted stock units   (2,515 )     (474 )
Proceeds from contributions to the employee stock purchase plan   970       1,089  
Repayment of principal portion of finance lease liabilities   (26 )     (36 )
Proceeds from issuance of term debt         10,000  
Net cash (used in) provided by financing activities   (1,553 )     10,644  
       
NET CHANGE IN CASH AND CASH EQUIVALENTS   (30,020 )     (15,892 )
Beginning of period   119,709       98,841  
End of period $ 89,689     $ 82,949  
               

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
March 31,
  2025   2024
(in thousands, except per share data)      
Adjusted Revenues      
Net revenues (GAAP) $ 87,988     $ 72,974  
Revenue associated with test reports delivered in prior periods   (787 )     (1,656 )
Adjusted revenues (Non-GAAP) $ 87,201     $ 71,318  
       
Adjusted Gross Margin      
Gross margin (GAAP)1 $ 43,280     $ 56,833  
Amortization of acquired intangible assets   28,325       2,247  
Revenue associated with test reports delivered in prior periods   (787 )     (1,656 )
Adjusted Gross Margin (Non-GAAP) $ 70,818     $ 57,424  
       
Gross Margin percentage (GAAP)2   49.2 %     77.9 %
Adjusted gross margin percentage (Non-GAAP)3   81.2 %     80.5 %
       
Adjusted Loss per Share, Basic and Diluted      
Net loss (GAAP) $ (25,848 )   $ (2,534 )
Amortization of acquired intangible assets4   20,099        
Adjusted Net Loss (Non-GAAP) $ (5,749 )   $ (2,534 )
       
Weighted-average shares outstanding, basic and diluted:   28,609       27,485  
       
Net loss per share, basic and diluted (GAAP)5 $ (0.90 )   $ (0.09 )
Adjusted Net Loss Per Share, Basic and Diluted (Non-GAAP)6 $ (0.20 )   $ (0.09 )
     
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
March 31,
  2025   2024
(in thousands)      
Adjusted EBITDA      
Net loss $ (25,848 )   $ (2,534 )
Interest income   (3,099 )     (2,996 )
Interest expense   17       14  
Income tax (benefit) expense   (423 )     45  
Depreciation and amortization expense   29,764       3,340  
Stock-based compensation expense   11,179       12,675  
Change in fair value of trading securities   1,425        
Adjusted EBITDA (Non-GAAP) $ 13,015     $ 10,544  
               


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