Castle Biosciences Q1 Revenue $83.7M; Core Test Reports Up 36%
Castle Biosciences posted Q1 revenue of $83.7 million, with DecisionDx-Melanoma and TissueCypher test volumes rising 16% and 58% year-over-year, respectively, driving a 36% increase in core test reports. The company raised its 2026 revenue guidance to $345–355 million after achieving a 73% gross margin.
1. First Quarter Financial Results
Castle Biosciences reported Q1 2026 revenue of $83.7 million, down from $88.0 million in Q1 2025. Net loss narrowed to $14.5 million, or $0.49 per share, and Adjusted EBITDA was negative $5.1 million on a 73% gross margin. Cash and investments totaled $261.7 million as of March 31.
2. Core Test Volume Growth
DecisionDx-Melanoma test reports rose 16% to 10,021, while TissueCypher reports jumped 58% to 11,745, driving a 36% increase in core revenue driver volumes year-over-year. Revenues for non-dermatologic tests expanded to $42.6 million from $25.0 million in the same period of 2025.
3. Guidance Raise and Clinical Evidence
Based on Q1 performance, the company raised full-year 2026 revenue guidance to $345–355 million from $340–350 million. Management highlighted new data showing a 2.6% sentinel lymph node positivity rate in low-risk patients, reinforcing DecisionDx-Melanoma’s role in biopsy decision-making.