Empowering people, informing care decisions February 2026 ©2026 Castle Biosciences 1 Disclaimers Forward Looking Statements This presentation contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the "safe harbor" created by those sections. These forward-looking statements include, but are not limited to, statements concerning: our positioning for continued grow ...

Core Insights - Castle Biosciences is expected to report Q3 2025 results on November 3, 2025, with anticipated earnings of ($0.35) per share and revenue of $71.062 million [1][2] - The company previously reported Q2 2025 earnings of $0.15 per share, exceeding estimates by $0.66, with revenue of $86.18 million, surpassing expectations of $71.53 million [3] - Analysts project a $0 EPS for the current fiscal year and a $-2 EPS for the next fiscal year [3] Financial Performance - Castle Biosciences has a market capitalization of $739.76 million, with a price-to-earnings ratio of -72.86 and a beta of 1.13 [4] - The stock has fluctuated between a fifty-two week low of $14.59 and a high of $35.84, with a current stock price of $25.50 [4] - The company maintains a debt-to-equity ratio of 0.02, a quick ratio of 6.69, and a current ratio of 6.85 [4] Insider Activity - Insider Derek J. Maetzold sold 1,339 shares at an average price of $22.44, totaling $30,047.16, resulting in a 2.08% decrease in his position [5] - Following the sale, Maetzold holds 62,988 shares valued at approximately $1.41 million [5] Institutional Holdings - Institutional investors own 92.60% of Castle Biosciences, with notable increases in holdings from several firms, including a 10,592% increase from Jones Financial Companies [6] - Other significant increases include a 256.9% boost from Tower Research Capital and a 15,811.5% increase from Amundi [6] Analyst Ratings - Weiss Ratings issued a "sell (d-)" rating, while Wall Street Zen upgraded the stock from "sell" to "hold" [7] - Canaccord Genuity maintains a "buy" rating with a price target of $37.00, and Zacks Research upgraded the stock to "strong-buy" [7][8] - The consensus rating is "Moderate Buy" with an average target price of $36.57 [8] Company Overview - Castle Biosciences specializes in molecular diagnostics, providing testing solutions for dermatologic cancers, Barrett's esophagus, uveal melanoma, and mental health conditions [9] - Key products include DecisionDx-Melanoma, DecisionDx-SCC, MyPath Melanoma, and TissueCypher, which assist in risk stratification and diagnosis [9]

Financial Performance & Growth - Q2 2025 total test reports for core revenue drivers (DecisionDx-Melanoma, TissueCypher) increased by 33% year-over-year compared to Q2 2024[14, 61] - Gross Margin for Q2 2025 was 77%, while Adjusted Gross Margin reached 80%, slightly lower than the 81% and 83% respectively in the same period of 2024[14] - Net cash provided by operations in Q2 2025 was $20.8 million, a decrease from $24.0 million in Q2 2024[14] - As of June 30, 2025, the company's cash, cash equivalents, and marketable investment securities totaled $275.9 million[14] - Net income for Q2 2025 was $4.5 million, and Adjusted EBITDA was $10.4 million[14] Strategic Initiatives - The company aims to achieve operating cash flow positivity by the end of 2025[4, 60] - The company closed its acquisition of Previse, a gastrointestinal health company, focusing on chronic acid reflux related diseases, including esophageal cancer[14] - The company entered into a collaboration and license agreement with SciBase to develop diagnostic tests for dermatologic diseases[14] Market Penetration & Clinical Utility - DecisionDx-Melanoma clinical use is associated with improved patient survival, with a 29% lower 3-year melanoma-specific mortality and a 17% lower 3-year overall mortality in tested patients compared to untested patients[38] - DecisionDx-SCC Class results predict an SCC patient's individual metastatic risk and individual benefit of ART[44] - TissueCypher is the strongest independent predictor of progression to HGD or EAC in Barrett's esophagus patients, detecting 62% of progressors[51, 52]

Summary of Castle Biosciences Conference Call Company Overview - Castle Biosciences focuses on improving patient health through innovative diagnostic test services, either developed internally or acquired [2][6] - The company aims to impact the patient journey through diagnostic support, risk stratification, and therapy selection [3][4] Key Products and Services - **MyPath Melanoma**: Aids dermatopathologists in determining if a melanoma biopsy is positive [3] - **DecisionDx SCC**: A test for high-risk squamous cell carcinoma patients, predicting responsiveness to radiation therapy [4][28] - **DecisionDx Melanoma**: Developed to answer clinical questions regarding melanoma progression and recurrence [7][16] - **TissueCipher**: For patients with Barrett's esophagus, identifying those at risk of progression to esophageal adenocarcinoma [5][11] Clinical Evidence and Impact - The **DECIDE study** showed that patients who avoided sentinel lymph node biopsy due to low-risk results had 100% recurrence-free survival at two years [8] - The use of DecisionDx tests led to a **29% improvement** in three-year melanoma-specific survival compared to matched patients not tested [18] - The DecisionDx SCC test demonstrated a **50% reduction** in metastasis rates for patients receiving adjuvant radiation therapy [29] Financial Performance - The company reported a strong balance sheet with **$275 million** in cash at the end of Q1 2025 [32][40] - Adjusted gross margins maintained at approximately **80-81%** over the last five quarters [37] - Operating cash flow showed a trend of growth, with **$23 million** in operating cash flow in the last three quarters of the previous year [38] Strategic Goals - Continue to drive robust test volume growth and maintain industry-leading gross margins [31][32] - Focus on optimizing commercialization investments, particularly in dermatology and gastroenterology [40][42] - Explore potential acquisitions to enhance value in existing markets [43][44] Market Dynamics - Seasonal trends affect revenue, with expectations of increased melanoma detection in warmer months [33][34] - The decision to discontinue the iGenics test was made due to reimbursement challenges, impacting overall test volume [35][36] Conclusion - Castle Biosciences is positioned for growth with a strong product pipeline and strategic focus on enhancing patient care through advanced diagnostic testing. The company aims to maintain financial stability while expanding its market presence in dermatology and gastroenterology.