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Castle Biosciences (CSTL) investor relations material
Castle Biosciences Q3 2025 earnings summary
Complete event summary combining all related documents: earnings call transcript, report, and slide presentation.Q3 2025 earnings summary3 Nov, 2025
Executive summary
Q3 2025 revenue was $83 million, with total test report volume at 26,841, reflecting strong performance in core dermatologic and gastrointestinal franchises, but a 3.2% year-over-year decline due to lower dermatologic ASPs and payer coverage changes.
Non-dermatologic revenue, especially TissueCypher, grew sharply (up 67% year-over-year), while core test volumes (DecisionDx-Melanoma, TissueCypher) increased 36% over Q3 2024.
Net loss for Q3 2025 was $0.5 million, compared to net income of $2.3 million in Q3 2024, reflecting lower gross margin and higher operating expenses.
Launched Advanced AD TX (AdvanceAD-TX), a gene expression test for guiding systemic treatment in moderate to severe atopic dermatitis, targeting a $33 billion US market with 13.2 million eligible patients aged 12 and older.
Full-year 2025 revenue guidance was raised to $327–335 million, up from $310–320 million.
Financial highlights
Q3 2025 revenue: $83 million; gross margin: 74.7–75% (down from 79.2% in Q3 2024); adjusted gross margin: 76.8–77%.
Operating expenses: $89.8 million (up from $80.7 million in Q3 2024); net loss: $0.5 million; adjusted EBITDA: $9.2 million (down from $21.6 million in Q3 2024).
Cash, cash equivalents, and marketable securities: $287.5 million as of September 30, 2025.
Net cash provided by operations: $22.6 million in Q3; $37.4 million for the nine months ended September 30, 2025.
For the nine months ended September 30, 2025, revenue was $257.2 million (up from $245.8 million), with a net loss of $21.8 million versus net income of $8.7 million in 2024.
Outlook and guidance
2025 revenue guidance raised to $327–335 million, up from prior $310–320 million.
Management expects continued growth in test volumes and top-line performance, with a focus on robust test volume growth, maintaining strong margins, and disciplined capital allocation.
Expect positive net cash flow from operations for 2025.
Advanced AD TX revenue contribution expected to be immaterial in 2026 as reimbursement is built from the ground up.
Future profitability depends on regaining Medicare coverage for DecisionDx-SCC and successful commercialization of pipeline products.
What drove the Q3 Adjusted EBITDA decline?
AdvanceAD-Tx: expected revenue contribution?
What drives confidence in raised 2025 revenue guidance?
AdvanceAD-Tx reimbursement pathways beyond Medicare?
SCC LCD reconsideration: What's next?
DecisionDx-Melanoma FDA approval benefit?
Advanced AD TX: Detail reimbursement pathways.
SCC: How does new evidence impact adoption?
Adjusted EBITDA decline drivers and outlook?
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Next Castle Biosciences earnings date
Stephens Annual Investment Conference19 Nov, 2025
Next Castle Biosciences earnings date
Stephens Annual Investment Conference19 Nov, 2025
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Frequently asked questions
Castle Biosciences, Inc., a commercial-stage dermatological cancer company, focuses to provide diagnostic and prognostic solutions for dermatological cancers. Castle Biosciences is a provider of products that assesses the response of cancer patients to treatment. The company's products include Immunoscore non-invasive test, which measures changes in proteins expressed on the surface of a person's tumor; CastleTRAC, a diagnostic tool for assessing the tissue response in four types of cutaneous T-cell lymphomas (CTCL); and CastleMAP for measuring the immune reaction to a specific drug. Castle Biosciences, Inc., is based in Friendswood, Texas.
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