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Castle Biosciences Inc.: Q2 FY2026 earnings call

What management said about Q2 FY2026, from the documents filed with the SEC on 30 July 2026: press release. Guidance figures: 1 raised. The quarter’s numbers.

Key takeaways

  • Revenue rose to $103.5 million: Revenue for the quarter was $103.5 million, compared with $86.2 million a year earlier. First-half revenue was $187.2 million, against $174.2 million. Source
  • Core test reports up 32%: Test reports for the core drivers, DecisionDx-Melanoma and TissueCypher, rose 32% year over year in the quarter and 34% in the first half. Source
  • TissueCypher reports rose to 14,988: Barrett’s Esophagus test reports were 14,988, compared with 9,170 a year earlier. First-half TissueCypher reports were 26,733, against 16,602. Source
  • Gross margin was 75%: Gross margin was 75% and Adjusted Gross Margin 76%, compared with 77% and 80% a year earlier. First-half gross margin was 74%, against 63%. Source
  • Adjusted EBITDA rose to $12.4 million: Adjusted EBITDA was $12.4 million, compared with $10.4 million. First-half Adjusted EBITDA was $7.3 million, against $23.4 million a year earlier. Source
  • Cash and securities totaled $266.8 million: Cash, cash equivalents and marketable investment securities were $266.8 million at June 30, 2026, up from $261.7 million at March 31, 2026. Source
  • AdvanceAD-Tx concordance study data: A multi-center study showed 54.3% of patients on baseline systemic therapy were initially on pathway-concordant treatment; after AdvanceAD-Tx testing, 97.8% were initiated on molecularly concordant therapy. Source

“The Castle Biosciences team delivered another outstanding quarter”

Derek Maetzold, president and chief executive officer of Castle Biosciences

Guidance

AreaPeriodFigureAgainst last quarter
Total revenue Sourcefull year 2026$365-375 millionRaised from $345-355 million

What changed from last quarter

  • Guidance raised: 2026 total revenue guidance raised to $365-375 million from $345-355 million. Source
  • New guidance: Positive Adjusted EBITDA now expected for the third quarter, fourth quarter and full year 2026. Source
  • New: DETECT-AD study began enrolling, with the first patient enrolled in June 2026 through the SciBase collaboration. Source

Results and growth drivers

  • Revenue rose to $103.5 million: Revenue for the quarter was $103.5 million, compared with $86.2 million a year earlier. First-half revenue was $187.2 million, against $174.2 million. Source
  • Core test reports up 32%: Test reports for the core drivers, DecisionDx-Melanoma and TissueCypher, rose 32% year over year in the quarter and 34% in the first half. Source
  • Prior-period adjustment lowered adjusted revenue: Adjusted revenues were $99.9 million, after a $3.7 million reduction for test reports delivered in prior periods. Source

Test report volumes by product

  • TissueCypher reports rose to 14,988: Barrett’s Esophagus test reports were 14,988, compared with 9,170 a year earlier. First-half TissueCypher reports were 26,733, against 16,602. Source
  • DecisionDx-Melanoma reports edged higher: DecisionDx-Melanoma reports were 10,280, against 9,981. First-half reports were 20,301, compared with 18,602 in the same period of 2025. Source
  • SCC and MyPath reports declined: DecisionDx-SCC reports were 4,011, against 4,762. MyPath Melanoma reports were 1,061, compared with 1,166 in the year-earlier quarter. Source
  • DecisionDx-UM reports up year over year: DecisionDx-UM test reports were 482, compared with 468 in the second quarter of 2025. First-half UM reports were 974, against 938. Source

“the dedication of our talented team to deliver results so that our clinician customers and patients can act with confidence”

Derek Maetzold, president and chief executive officer of Castle Biosciences

Gross margin and operating costs

  • Gross margin was 75%: Gross margin was 75% and Adjusted Gross Margin 76%, compared with 77% and 80% a year earlier. First-half gross margin was 74%, against 63%. Source
  • SG&A expense rose to $66.1 million: Selling, general and administrative expense was $66.1 million, against $58.1 million. Research and development was $14.5 million, compared with $12.8 million. Source
  • Cost of sales rose to $23.7 million: Cost of sales, excluding acquired intangible amortization, was $23.7 million, against $17.6 million. Acquired intangible amortization was $2.3 million, compared with $2.0 million. Source
  • Stock-based compensation was $11.6 million: Stock-based compensation expense was $11.6 million in the quarter, compared with $11.2 million a year earlier, and $21.4 million in the first half. Source

Net loss and Adjusted EBITDA

  • Net loss was $2.1 million: Net loss was $2.1 million, or $0.07 per diluted share, compared with net income of $4.5 million, or $0.15 per diluted share, a year earlier. Source
  • Adjusted EBITDA rose to $12.4 million: Adjusted EBITDA was $12.4 million, compared with $10.4 million. First-half Adjusted EBITDA was $7.3 million, against $23.4 million a year earlier. Source
  • First-half net loss was $16.6 million: First-half net loss was $16.6 million, or $0.55 per share, compared with $21.3 million, or $0.74 per share, in the first half of 2025. Source

Cash, capital and balance sheet

  • Quarter operating cash was $15.2 million: Operating cash flow was $15.2 million in the quarter, against $20.8 million a year earlier. Source
  • First-half operations used cash: Net cash used in operations was $6.9 million for the first half, compared with $14.8 million provided in the same period of 2025. Source
  • Cash and securities totaled $266.8 million: Cash, cash equivalents and marketable investment securities were $266.8 million at June 30, 2026, up from $261.7 million at March 31, 2026. Source
  • Equipment purchases reached $21.1 million: Purchases of property and equipment were $21.1 million for the first half, against $14.0 million a year earlier. Property and equipment, net, was $104.7 million at June 30. Source
  • Debt balances at quarter end: Current portion of long-term debt was $2.9 million and long-term debt was $7.2 million at June 30, 2026. Source

Clinical evidence, pipeline and recognition

  • AdvanceAD-Tx concordance study data: A multi-center study showed 54.3% of patients on baseline systemic therapy were initially on pathway-concordant treatment; after AdvanceAD-Tx testing, 97.8% were initiated on molecularly concordant therapy. Source
  • DecisionDx-Melanoma SLNB study published: A publication in Dermatology and Therapy reported that the i31-SLNB result outperforms the MIA nomogram in identifying low and high risk of SLN positivity. Source
  • AdvanceAD-Tx gains New York approval: AdvanceAD-Tx received assay approval from the New York State Department of Health. Castle now has New York State approval for all tests in its dermatology and ophthalmology portfolios. Source
  • DETECT-AD first patient enrolled: The first DETECT-AD patient was enrolled in June 2026. The study, run with SciBase, will examine electrical impedance spectroscopy for predicting atopic dermatitis flare onset. Source
  • AdvanceAD-Tx wins innovation award: AdvanceAD-Tx was selected as winner of the Genomics Innovation Award in the 10th annual MedTech Breakthrough Awards program, the company's fifth such award. Source
  • CFO named Houston business honoree: Chief financial officer Frank Stokes was named a 2026 CFO Awards honoree by the Houston Business Journal, one of 22 CFOs recognized in the area. Source

Coming up, as management said on 30 July 2026

  • DETECT-AD study underway: The study will examine whether electrical impedance spectroscopy predicts atopic dermatitis flare onset, with the goal of enabling proactive interventions. Source

Figures management reported

FigureReported
Patient volumes (test reports) SourceCore drivers up 32% in the quarter and 34% in the first half

Risks management discussed

  • Regulatory: A change in DecisionDx-SCC Medicare coverage, effective April 24, 2025, affected second quarter 2026 revenue. Source
  • Demand: The re-focus of commercial efforts and the May 2025 discontinuation of IDgenetix affected revenue in the period. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.