Castle Biosciences (NasdaqGM:CSTL) FY Conference Transcript

Summary of Castle Biosciences FY Conference Call Company Overview - Castle Biosciences is a molecular diagnostics company focused on proprietary algorithm-driven tests aimed at improving patient management and outcomes [2][3] Industry and Market Insights - The company operates primarily in the dermatology and gastroenterology sectors, with tests designed for conditions such as melanoma, atopic dermatitis, and Barrett's esophagus [5][7] - The total addressable market (TAM) for their tests is significant, with estimates of $540 million for melanoma tests, $820 million for high-risk cutaneous squamous cell carcinoma, and $1 billion for Barrett's esophagus [9][10][11] Financial Performance - In Q3 2025, Castle Biosciences reported a revenue growth of 36% year-over-year, matching the volume growth [2] - Adjusted gross margins decreased to 77% from 82% due to the loss of coverage for squamous cell carcinoma tests [3] - The company ended the quarter with cash and cash equivalents of $287 million, indicating a strong balance sheet [3] Product Developments - The company launched a new test called Advance ADTX for guiding systemic therapy selection in patients with moderate to severe atopic dermatitis [4] - The DecisionDx-SCC test demonstrated the ability to predict the likelihood of response to adjuvant radiation therapy in high-risk cutaneous squamous cell carcinoma patients [6] - Ongoing collaboration with SciBase aims to predict flares in atopic dermatitis patients using electrical impedance spectroscopy technology [7] Clinical Study Findings - A large prospective observational study validated a 487 gene expression profile test for atopic dermatitis, identifying two key profiles: TH2 molecular profile and JAK inhibitor responder profile [12][19] - Patients with a JAK inhibitor responder profile had a 45% chance of achieving EASI-90 (90% clearance) when treated with JAK inhibitors, compared to only 8.3% with TH2 biologic therapy [19] Market Research and Adoption - Approximately 78% of clinicians surveyed indicated they would likely use the new atopic dermatitis test after a brief overview [20] - The target population for the atopic dermatitis test is around 13 million patients aged 12 and older in the U.S. [10][22] Conclusion - Castle Biosciences is positioned for growth with a strong product pipeline and significant market opportunities in dermatology and gastroenterology, supported by promising clinical data and positive clinician feedback [23]