Castle ups guidance on strong test volumes

 

Castle Biosciences beats Q1 2026 estimates with non-GAAP EPS -$0.49, revenue $84.2M, raises 2026 guidance to $345–355M on robust test volumes

• Non-GAAP EPS of -0.49 improved 46% year over year in fiscal Q1 2026.
• Q1 2026 revenue of $84.2M declined 3% year over year.
• Revenue $83.7m; core test volumes +36% YoY, driven by melanoma and TissueCypher.
• Full-year 2026 revenue guidance raised to $345–355m from $340–350m, excluding SCC/IDgenetix.
• TissueCypher test reports 11,745 (+58% YoY); slight sequential dip attributed to GI seasonality.
• DecisionDx-Melanoma reports 10,021 (+16% YoY); management still guides mid- to high-single-digit 2026 growth.
• AdvanceAD-Tx received ~650 orders in limited rollout; reimbursement clarity expected by Q3 2026.
• Gross margin 72.8% vs 49.2% prior-year; adjusted gross margin down to 75.6%.
• Net loss improved to $14.5m; operating cash outflow $22.1m; cash balance $261.7m.
• Key risks: reimbursement outcomes for AdvanceAD-Tx and DecisionDx-SCC, NCCN guideline headwinds in melanoma.
• Management tone confident; highlighting record March/April volumes and intent to leverage sub-100-rep salesforce.
• Analysts focused on TissueCypher ramp, AD-Tx monetization path, margins, M&A strategy, and Medicare reconsiderations.
• Main concern: Uncertain reimbursement and coverage decisions for key existing and new tests.
• Strong quarter, driven by robust test volume growth and a modest guidance raise.

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