Castle Biosciences (CSTL)
NASDAQ:CSTL
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Castle Biosciences
(NASDAQ:CSTL)
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Rating:67Neutral
Price Target:
$24.00
▼(-4.19% Downside)
Action:Reiterated
Date:05/30/26
The score is driven primarily by solid financial footing (low leverage, positive operating cash flow) and a constructive earnings-call update with raised 2026 revenue guidance and strong core test volume growth. These positives are tempered by weaker recent fundamentals (TTM revenue/profitability softness and sharply lower TTM free cash flow), mixed-to-weak technical trend signals, and a negative P/E tied to ongoing losses.
Positive Factors
Commercial Test Volume Growth
Sustained high single‑digit to mid‑double digit core volume growth indicates durable clinical adoption of DecisionDx and related assays. Higher, repeatable test volumes strengthen revenue visibility, improve per‑test economics through scale, and underpin multi‑year revenue growth assumptions.
Negative Factors
Profitability Volatility
Earnings have swung from profitability to losses, with adjusted EBITDA still negative and margins compressed versus prior years. Persistent volatility makes sustainable operating leverage uncertain and means management must convert volume growth into consistent margin recovery to deliver durable profits.
Read all positive and negative factors
Positive Factors
Negative Factors
Commercial Test Volume Growth
Sustained high single‑digit to mid‑double digit core volume growth indicates durable clinical adoption of DecisionDx and related assays. Higher, repeatable test volumes strengthen revenue visibility, improve per‑test economics through scale, and underpin multi‑year revenue growth assumptions.
Read all positive factors
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.
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The Fly
The FlyCastle Biosciences (CSTL) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$670.60M
Dividend YieldN/A
Average Volume (3M)450.82K
Price to Earnings (P/E)―
Beta (1Y)0.46
Revenue Growth-2.06%
EPS Growth-169.07%
CountryUS
Employees784
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-0.43
Shares Outstanding30,329,952
10 Day Avg. Volume443,560
30 Day Avg. Volume450,818
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 Cap0.91
Enterprise Value/Revenue1.80
Enterprise Value/Gross Profit2.34
Enterprise Value/Ebitda-127.87
Forecast
1Y Price Target
$42.83Price Target Upside70.99% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering6
EPS Forecast (FY)-1.43
Revenue Forecast (FY)$352.40M
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 Earnings Call Summary
Earnings Call Date:May 06, 2026
(Q1-2026)
| % Change Since: |
Next Earnings Date:Aug 10, 2026
Earnings Call Sentiment Positive
The call communicated strong commercial momentum across core products—notably DecisionDx‑Melanoma and TissueCypher—with significant year‑over‑year test volume growth (36% core volumes; 58% TissueCypher) and an uplifted full‑year revenue guide. Profitability metrics improved versus prior year (narrower net loss, improved adjusted EBITDA) and the balance sheet remains solid with ~$261.7M in cash and marketable securities. Key negatives are an adjusted gross margin decline versus the prior comparable period, continued negative adjusted EBITDA (albeit improved), operating cash use in Q1, ongoing reimbursement and timing uncertainty for DecisionDx‑SCC and for broad commercialization of Advanced ADTx, and higher operating costs tied to growth and capacity investments. On balance, the positive commercial traction, raised guidance, improving profitability trends, and healthy liquidity outweigh the remaining execution and reimbursement risks.Positive Updates
Strong Q1 Revenue and Raised Full-Year Guidance
Revenue of $83.7 million in Q1 2026. Company raised 2026 revenue guidance to $345 million–$355 million (from $340 million–$350 million), representing high‑teens to low‑20s growth in 2026 over 2025 on an excl. DecisionDx‑SCC and ID Genetics basis.
Negative Updates
Adjusted Gross Margin Contraction
Adjusted gross margin declined to 75.6% in Q1 2026 from 81.2% in Q1 2025, a decrease of ~5.6 percentage points, reflecting mix and other period adjustments.
Read all updates
Q1-2026 Updates
Positive
Negative
Strong Q1 Revenue and Raised Full-Year Guidance
Revenue of $83.7 million in Q1 2026. Company raised 2026 revenue guidance to $345 million–$355 million (from $340 million–$350 million), representing high‑teens to low‑20s growth in 2026 over 2025 on an excl. DecisionDx‑SCC and ID Genetics basis.
Read all positive updates
Company Guidance
Castle raised 2026 revenue guidance to $345–$355 million (up from $340–$350M), implying high‑teens to low‑20s revenue growth in 2026 versus 2025 (ex‑DecisionDx‑SCC and ID Genetics); Q1 revenue was $83.7M with adjusted EBITDA of negative $5.1M, GAAP gross margin 72.8% (adjusted gross margin 75.6%), and cash, cash equivalents and marketable securities of $261.7M as of 3/31/26. Management reaffirmed mid‑ to high‑single‑digit full‑year volume growth for DecisionDx‑Melanoma after Q1 delivered 10,021 reports (+16% YoY, March a record month), and expects TissueCypher to add a similar number of tests in 2026 as in 2025 (Q1: 11,745 reports vs 7,432 in 2025, +58% YoY; full‑year growth approaching ~50%). They reported ~650 Advanced ADTx orders in Q1 and expect clearer reimbursement visibility by end‑Q3 2026, continue to target an FDA submission for melanoma in 2026, and plan to fund growth while evaluating M&A.Castle Biosciences Financial Statement Overview
Summary
Income Statement
56
Neutral
Balance Sheet
83
Very Positive
Cash Flow
70
Positive
| Breakdown | TTM | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 339.92M | 344.23M | 332.07M | 219.79M | 137.04M | 94.08M |
| Gross Profit | 261.97M | 273.20M | 271.86M | 174.81M | 105.03M | 78.26M |
| EBITDA | -4.79M | 11.34M | 38.14M | -45.02M | -58.34M | -36.60M |
| Net Income | -12.83M | -24.16M | 18.25M | -57.47M | -67.14M | -31.29M |
Balance Sheet | ||||||
| Total Assets | 547.80M | 578.56M | 531.24M | 453.34M | 447.33M | 462.57M |
| Cash, Cash Equivalents and Short-Term Investments | 261.69M | 299.50M | 293.13M | 243.10M | 258.63M | 329.63M |
| Total Debt | 36.72M | 36.91M | 26.34M | 15.34M | 13.40M | 8.20M |
| Total Liabilities | 86.39M | 107.68M | 75.40M | 62.07M | 48.18M | 50.83M |
| Stockholders Equity | 461.42M | 470.87M | 455.83M | 391.27M | 399.15M | 411.74M |
Cash Flow | ||||||
| Free Cash Flow | 4.52M | 28.33M | 36.54M | -19.25M | -47.29M | -22.47M |
| Operating Cash Flow | 48.25M | 64.35M | 64.87M | -5.63M | -41.66M | -18.98M |
| Investing Cash Flow | -63.74M | -60.37M | -50.14M | -16.18M | -166.54M | -66.66M |
| Financing Cash Flow | -10.44M | -6.96M | 6.14M | -2.30M | 1.51M | 5.42M |
Castle Biosciences Technical Analysis
Neutral
25.05
Price Trends
23.08
Negative
28.51
Negative
28.74
Negative
Market Momentum
-0.80
Negative
47.46
Neutral
84.97
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For CSTL, the sentiment is Neutral. The current price of 25.05 is above the 20-day moving average (MA) of 20.80, above the 50-day MA of 23.08, and below the 200-day MA of 28.74, indicating a neutral trend. The MACD of -0.80 indicates Negative momentum. The RSI at 47.46 is Neutral, neither overbought nor oversold. The STOCH value of 84.97 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral 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 |
|---|---|---|---|---|---|---|---|
71 Outperform | $1.17B | -142.47 | -2.61% | ― | 19.17% | -111.99% | |
67 Neutral | $670.60M | -49.10 | -2.77% | ― | -2.06% | -169.07% | |
57 Neutral | $1.33B | -2.74 | -11.82% | ― | 10.95% | -26.52% | |
56 Neutral | $518.03M | -7.59 | -6.70% | ― | 9.54% | -79.16% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
50 Neutral | $1.15B | -12.43 | -43.52% | ― | -24.71% | 21.16% | |
49 Neutral | $398.57M | -0.93 | -109.09% | ― | -0.28% | -286.80% |
* Healthcare Sector Average
CSTL
Castle Biosciences
21.08
4.81
29.56%
MYGN
Myriad Genetics
3.97
-0.49
-10.99%
NEO
NeoGenomics
10.52
3.35
46.72%
CDNA
CareDx
22.82
5.74
33.61%
FLGT
Fulgent Genetics
18.14
-2.53
-12.24%
PSNL
Personalis
11.40
6.57
136.02%
Castle Biosciences Corporate Events
Executive/Board ChangesShareholder Meetings
Castle Biosciences Shareholders Back Board, Governance and Pay
Positive
May 29, 2026
On May 28, 2026, Castle Biosciences, Inc. held its 2026 annual meeting of stockholders, where shareholders elected three Class I directors — Ellen Goldberg, Miles D. Harrison and Tiffany P. Olson — to serve until the 2029 annual meetin...
Business Operations and StrategyFinancial Disclosures
Castle Biosciences Posts Strong Q1 Results, Raises 2026 Guidance
Positive
May 6, 2026
Castle Biosciences reported first-quarter 2026 results on May 6, 2026, posting revenue of $83.7 million and a 36% year-over-year increase in test volumes for its core DecisionDx-Melanoma and TissueCypher assays, despite lower overall revenue than ...
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.