Castle Biosciences (CSTL)
NASDAQ:CSTL
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Castle Biosciences
(NASDAQ:CSTL)
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Rating:60Neutral
Price Target:
$24.50
▲(4.12% Upside)
Action:ReiteratedDate:02/28/26
The score is supported most by solid underlying financial strength (low leverage, improving cash generation, strong multi-year revenue growth) and a constructive earnings outlook for continued core-franchise growth. It is held back by inconsistent profitability/margin pressure and reimbursement-related uncertainty, alongside bearish technical momentum and limited valuation support due to losses and no dividend.
Positive Factors
Consistent test volume growth
Sustained 37% annual test volume growth indicates durable clinical adoption and recurring revenue from clinician-ordered diagnostics. Growing ordering clinician base and higher penetration create a predictable revenue driver that supports mid-term topline resilience despite episodic headwinds.
Negative Factors
Profitability volatility
Swinging from meaningful profit in 2024 to a net loss in 2025 underscores unstable earnings power. Volatile net income and adjusted EBITDA reduce predictability of returns, constrain reinvestment capacity, and increase dependency on cash reserves to bridge operating fluctuations.
Read all positive and negative factors
Positive Factors
Negative Factors
Consistent test volume growth
Sustained 37% annual test volume growth indicates durable clinical adoption and recurring revenue from clinician-ordered diagnostics. Growing ordering clinician base and higher penetration create a predictable revenue driver that supports mid-term topline resilience despite episodic headwinds.
Read all positive factors
Castle Biosciences (CSTL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$699.58M
Dividend YieldN/A
Average Volume (3M)329.77K
Price to Earnings (P/E)―
Beta (1Y)0.53
Revenue Growth10.15%
EPS Growth-295.52%
CountryUS
Employees784
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-0.08
Shares Outstanding29,731,197
10 Day Avg. Volume283,656
30 Day Avg. Volume329,772
Financial Highlights & Ratios
PEG Ratio0.21
Price to Book (P/B)2.39
Price to Sales (P/S)3.28
P/FCF Ratio39.81
Enterprise Value/Market Cap0.92
Enterprise Value/Revenue1.87
Enterprise Value/Gross Profit2.73
Enterprise Value/Ebitda49.09
Forecast
1Y Price Target
$48.60Price Target Upside106.54% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering5
EPS Forecast (FY)-1.18
Revenue Forecast (FY)$345.63M
Castle Biosciences Business Overview & Revenue Model
Company Description
Castle Biosciences, Inc., a commercial-stage diagnostics company, focuses to provide diagnostic and prognostic testing services for dermatological cancers. Its lead product is DecisionDx-Melanoma, a multi-gene expression profile (GEP) test to iden...
How the Company Makes Money
Castle Biosciences primarily makes money by providing proprietary molecular diagnostic testing services and recognizing revenue when those tests are performed and delivered (i.e., clinical testing revenue). The core revenue stream comes from clini...
Castle Biosciences Key Performance Indicators (KPIs)
Any
Net Revenue by Segment
Shows how much money each part of the business brings in — for Castle Biosciences that typically means different diagnostic tests, services, and regions. Reveals whether growth is coming from a single flagship test or from broader product adoption, highlights concentration risk if one segment dominates, and points to where reimbursement, pricing, or commercial efforts are succeeding or need more investment.
Shows how much money each part of the business brings in — for Castle Biosciences that typically means different diagnostic tests, services, and regions. Reveals whether growth is coming from a single flagship test or from broader product adoption, highlights concentration risk if one segment dominates, and points to where reimbursement, pricing, or commercial efforts are succeeding or need more investment.
Data provided by:
The Fly
The FlyCastle Biosciences Earnings Call Summary
Earnings Call Date:Feb 26, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:May 11, 2026
Earnings Call Sentiment Neutral
The call highlighted strong commercial momentum across core franchises with notable volume growth (105K total test reports, +37%; TissueCypher +86%) and promising early uptake of new products (AdvanceAD-Tx ~500 orders in initial period). The company has a healthy cash balance (~$299.5M) and generated positive free cash flow in 2025. However, profitability and margin metrics deteriorated materially year-over-year (full year net loss $24.2M, adjusted EBITDA down to $44M from $75M, gross margin compressed to 69.2%), driven by lost DecisionDx-SCC revenue, a one-time amortization charge and higher operating expenses. Additional near-term risks include guideline and reimbursement uncertainties and timing for FDA clearance and reimbursement for new tests. Overall the operational growth story and cash strength balance against weakened profitability and reimbursement/timing risks.Positive Updates
Full Year and Q4 Revenue Beat
Q4 2025 revenue of $87.0M and full year 2025 revenue of $344.2M, which exceeded guidance.
Negative Updates
Full Year Profitability Decline
Net loss for full year 2025 of $24.2M versus net income of $18.2M in 2024; diluted loss per share $0.83 for 2025 versus diluted earnings per share $0.62 in 2024.
Read all updates
Q4-2025 Updates
Positive
Negative
Full Year and Q4 Revenue Beat
Q4 2025 revenue of $87.0M and full year 2025 revenue of $344.2M, which exceeded guidance.
Read all positive updates
Company Guidance
Castle guided 2026 total revenue of $340–$350 million (stated as mid‑ to high‑teens growth versus 2025 on an apples‑to‑apples basis excluding DecisionDx‑SCC and IDgenetix), with growth driven by continued DecisionDx‑Melanoma and TissueCypher momentum; management expects operating expenses to increase moderately in 2026, capital expenditures to decline from $36.0 million in 2025, immaterial revenue from AdvanceAD‑Tx in 2026 (material contribution expected in 2027–2028), and no 2026 revenue assumed for DecisionDx‑SCC, with more reimbursement detail expected in 2H26—contextual metrics cited on the call include 2025 revenue of $344.2 million (Q4 $87.0M), adjusted EBITDA of $44.0 million for 2025, DecisionDx‑Melanoma volumes of 39,083 reports in 2025 (+9% YoY) with ~31% patient penetration and ~17,000 total ordering clinicians, TissueCypher volumes of 39,014 reports in 2025 (+86% YoY) with ~11% patient penetration and 2,082 new ordering clinicians, and $299.5 million of cash, cash equivalents and marketable securities as of 12/31/25.Castle Biosciences Financial Statement Overview
Summary
Income Statement
58
Neutral
Balance Sheet
82
Very Positive
Cash Flow
71
Positive
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 344.23M | 332.07M | 219.79M | 137.04M | 94.08M |
| Gross Profit | 236.35M | 271.86M | 174.81M | 105.03M | 78.26M |
| EBITDA | 11.34M | 38.14M | -45.02M | -58.34M | -36.60M |
| Net Income | -24.16M | 18.25M | -57.47M | -67.14M | -31.29M |
Balance Sheet | |||||
| Total Assets | 578.56M | 531.24M | 453.34M | 447.33M | 462.57M |
| Cash, Cash Equivalents and Short-Term Investments | 299.50M | 293.13M | 243.10M | 258.63M | 329.63M |
| Total Debt | 36.91M | 26.34M | 15.34M | 13.40M | 8.20M |
| Total Liabilities | 107.68M | 75.40M | 62.07M | 48.18M | 50.83M |
| Stockholders Equity | 470.87M | 455.83M | 391.27M | 399.15M | 411.74M |
Cash Flow | |||||
| Free Cash Flow | 28.33M | 36.54M | -19.25M | -47.29M | -22.47M |
| Operating Cash Flow | 64.35M | 64.87M | -5.63M | -41.66M | -18.98M |
| Investing Cash Flow | -60.37M | -50.14M | -16.18M | -166.54M | -66.66M |
| Financing Cash Flow | -6.96M | 6.14M | -2.30M | 1.51M | 5.42M |
Castle Biosciences Technical Analysis
Negative
23.53
Price Trends
28.47
Negative
33.89
Negative
28.08
Negative
Market Momentum
-1.32
Negative
34.27
Neutral
22.84
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For CSTL, the sentiment is Negative. The current price of 23.53 is below the 20-day moving average (MA) of 24.77, below the 50-day MA of 28.47, and below the 200-day MA of 28.08, indicating a bearish trend. The MACD of -1.32 indicates Negative momentum. The RSI at 34.27 is Neutral, neither overbought nor oversold. The STOCH value of 22.84 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for CSTL.
Castle Biosciences Risk Analysis
Castle Biosciences disclosed 77 risk factors in its most recent earnings report. Castle Biosciences reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Castle Biosciences Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
60 Neutral | $699.58M | -46.67 | -5.27% | ― | 10.15% | -295.52% | |
56 Neutral | $861.97M | -47.01 | -6.47% | ― | 14.46% | ― | |
52 Neutral | $1.04B | -2.79 | -12.64% | ― | 10.10% | -44.29% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
50 Neutral | $477.83M | -13.36 | -5.40% | ― | 13.60% | 74.64% | |
49 Neutral | $629.88M | ― | -39.13% | ― | -21.02% | 47.74% | |
48 Neutral | $429.20M | -1.57 | -79.81% | ― | 0.21% | -233.51% |
* Healthcare Sector Average
CSTL
Castle Biosciences
24.37
3.32
15.77%
MYGN
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4.91
-3.10
-38.70%
NEO
NeoGenomics
8.35
-1.15
-12.11%
CDNA
CareDx
17.63
-1.53
-7.99%
FLGT
Fulgent Genetics
16.02
-3.06
-16.04%
PSNL
Personalis
6.68
3.42
104.91%
Castle Biosciences Corporate Events
Business Operations and StrategyFinancial Disclosures
Castle Biosciences Posts Modest 2025 Growth Amid Headwinds
Neutral
Feb 26, 2026
On Feb. 26, 2026, Castle Biosciences reported fourth-quarter and full-year 2025 results, posting 2025 revenue of $344.2 million, up 4% year over year and above guidance, with core tests DecisionDx-Melanoma and TissueCypher driving a 37% increase i...
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.