Castle Biosciences (CSTL) Q3 2026 earnings summary

Executive summary

• Q3 revenue rose 23.9% YoY to $102.9M, led by TissueCypher report volume growth of 47%; nine-month revenue increased 12.8% to $290.1M.

• FY2026 revenue guidance increased to $385M–$395M from $365M–$375M; Q3 Adjusted EBITDA was $12.7M.

Financial highlights

• Q3 GAAP revenue was $102.891M; Adjusted Revenue was $101.947M after a $944K net adjustment for reports delivered in prior periods.

• Q3 net loss was $4.1M versus $0.5M YoY; nine-month net loss narrowed to $20.7M from $21.8M.

• Q3 operating loss improved to $2.7M from $6.8M; nine-month operating loss improved to $24.2M from $39.0M.

• Q3 Adjusted EBITDA was $12.719M versus $9.2M YoY; nine-month Adjusted EBITDA was $20.0M versus $32.5M.

• Q3 operating expenses, including cost of sales, were $105.6M versus $89.8M YoY; higher costs reflected staffing, growth support and operating needs.

Outlook and guidance

• FY2026 revenue guidance rose to $385M–$395M from $365M–$375M, a $20M increase at the midpoint and a $45M increase from initial February guidance.

• The guidance increase primarily reflects expected TissueCypher volume growth and, to a lesser extent, ASP improvement; TissueCypher volume growth guidance remains 50%–52%.

• Positive Adjusted EBITDA is expected in Q4 and full-year 2026, and in FY2027 assuming no change in strategic direction.

• DecisionDx-Melanoma volume growth is expected in the mid-single digits for FY2026; Q4 may be seasonally lighter due to holiday disruptions in medical practices.