Castle Biosciences Reports Strong 2024 Results, Exceeds Revenue Guidance

Castle Biosciences, Inc. (Nasdaq: CSTL), a leading diagnostics company focused on improving health through innovative tests that guide patient care, today announced its preliminary, unaudited financial results for the fourth quarter and full year ended Dec. 31, 2024. The company reported strong performance across its therapeutic areas, with significant test adoption growth for its core products and expanded clinical evidence supporting their use.

Fourth Quarter and Full-Year 2024 Highlights

* Delivered 24,071 total test reports in the fourth quarter of 2024, compared to 20,284 in the same period of 2023, an increase of 19%.
* DecisionDx®-Melanoma test reports delivered in the quarter were 8,672, compared to 8,591 in the fourth quarter of 2023, an increase of 1%.
* DecisionDx®-SCC test reports delivered in the quarter were 4,299, compared to 3,530 in the fourth quarter of 2023, an increase of 22%.
* MyPath® Melanoma test reports delivered in the quarter were 879, compared to 1,018 in the fourth quarter of 2023, a decrease of 14%.
* TissueCypher® Barrett’s Esophagus test reports delivered in the quarter were 6,672 compared to 3,441 in the fourth quarter of 2023, an increase of 94%.
* IDgenetix® test reports delivered in the quarter were 3,125 compared to 3,299 in the fourth quarter of 2023, a decrease of 5%.
* DecisionDx®-UM test reports delivered in the quarter were 424, compared to 405 in the fourth quarter of 2023, an increase of 5%.
* The Company expects to meet or exceed the top end of its full-year 2024 revenue guidance of $320-330 million.
* Delivered 96,071 total test reports in 2024, compared to 70,429 in the same period of 2023, an increase of 36%.
* DecisionDx-Melanoma test reports delivered in 2024 were 36,008, compared to 33,330 in 2023, an increase of 8%.
* DecisionDx-SCC test reports delivered in 2024 were 16,348, compared to 11,442 in 2023, an increase of 43%.
* MyPath Melanoma test reports delivered in 2024 were 3,909, compared to 3,962 in 2023, a decrease of 1%.
* TissueCypher Barrett’s Esophagus test reports delivered in 2024 were 20,956 compared to 9,100 in 2023, an increase of 130%.
* IDgenetix test reports delivered in 2024 were 17,151, compared to 10,921 in 2023, an increase of 57%.
* DecisionDx-UM test reports delivered in 2024 were 1,699, compared to 1,674 in 2023, an increase of 1%.
* Year-end 2024 cash, cash equivalents, and marketable investment securities are expected to be approximately $293 million.

Key Drivers of Growth

Castle Biosciences' strong performance in 2024 can be attributed to several key drivers:

1. Expanded Clinical Evidence: The Company has made significant strides in expanding the clinical evidence supporting the use of its tests. In 2024, a new study was published that confirmed the use of DecisionDx-SCC in identifying which patients with high-risk cutaneous squamous cell carcinoma (SCC) will have a low or high likelihood of benefiting from adjuvant radiation therapy (ART). This was the second study in 2024 to demonstrate this utility of the test, further validating its importance in clinical decision-making.
2. Increased Adoption by Clinicians: The growing body of evidence supporting the use of these tests, along with the Company's efforts to raise awareness among clinicians, has likely contributed to increased adoption of these tests in clinical practice. This is reflected in the significant test report volume growth for both DecisionDx-SCC (43% increase in 2024) and TissueCypher Barrett’s Esophagus (130% increase in 2024).
3. Growth Initiatives: The Company's strategic growth initiatives, such as modifications to promotional investments for IDgenetix (shifting resources to inside sales and non-personal promotion), have also likely contributed to the increased test report volume. These initiatives demonstrate the Company's commitment to driving growth and improving patient care.
4. Market Demand: The increasing prevalence of skin cancers and Barrett's esophagus, coupled with the growing recognition of the importance of early detection and personalized treatment, has likely driven demand for these tests. This market demand, combined with the Company's strong performance and commitment to innovation, has contributed to the significant increase in test report volume.

Conclusion

Castle Biosciences' preliminary, unaudited financial results for the fourth quarter and full year ended Dec. 31, 2024, demonstrate the Company's strong performance and commitment to driving growth and improving patient care. With expanded clinical evidence supporting the use of its tests, increased adoption by clinicians, strategic growth initiatives, and market demand, Castle Biosciences is well-positioned to continue its success in the coming years. The Company's expectation to meet or exceed the top end of its full-year 2024 revenue guidance of $320-330 million further underscores its strong performance and commitment to delivering value to its stockholders while advancing its mission of improving health through innovative tests that guide patient care.