Castle Biosciences, Inc. · NASDAQ:CSTL
Castle Biosciences — Q1 2025 Earnings Presentation
24 slides from Castle Biosciences's earnings presentation, May 5, 2025
Slide 1: First Quarter 2025
©2025 Castle Biosciences 1 Empowering people, informing care decisions First Quarter 2025 May 5, 2025
Slide 2: Disclaimers: Forward-Looking Statements
©2025 Castle Biosciences 2 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 harb
Slide 3: Disclaimers: Financial Information; Non-GAAP Financial Measures
©2025 Castle Biosciences 3 Disclaimers Financial Information; Non-GAAP Financial Measures In this presentation, we use the metrics of Adjusted Revenues, Adjusted Gross Margin and Adjusted EBITDA, which are non-GAAP financial measures and are not calculated in accordance with generally accepted accou
Slide 4: Registered Trademarks
©2025 Castle Biosciences 4 Registered Trademarks DecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC, MyPath Melanoma, DiffDx- Melanoma, TissueCypher, IDgenetix, DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences, Inc.
Slide 5: Proven strategy designed to drive value creation for our stakeholders
©2025 Castle Biosciences 5 Proven strategy designed to drive value creation for our stakeholders FOCUS on best/first-in-class tests with high, unmet clinical need and significant market opportunity BUILD robust clinical evidence PENETRATE target markets to further test adoption by clinicians and pay
Slide 6: Key Q1 2025 and recent results
©2025 Castle Biosciences 6 Key Q1 2025 and recent results 1 Received a 2025 Top Workplace USA award for an exceptional workplace culture, our fourth year in a row to receive this national distinction Gross Margin for Q125 was 49%, and Adjusted Gross Margin was 81%, compared to 78% and 81% respective
Slide 7: Castle to acquire Previse
©2025 Castle Biosciences 7 Castle to acquire Previse About Previse • Gastrointestinal (GI) health company with a commercial stage methylation-based Barrett’s esophagus biomarker technology (Esopredict®) discovered at Johns Hopkins University in Dr. Steven Meltzer’s lab • >20 years of research and $2
Slide 8: DecisionDx-Melanoma CONNECTION study predicting low risk of SLN positivity
©2025 Castle Biosciences 8 Data from the DecisionDx-Melanoma prospective, multicenter CONNECTION study was successful at predicting which patients with T1 tumors have a low risk of SLN positivity DecisionDx-Melanoma correctly identified a population of patients with low risk of SLN positivity who co
Slide 9: Recurrence-free survival in low-risk DecisionDx-Melanoma patients who did not undergo SLNB
©2025 Castle Biosciences 9 Patients with low-risk DecisionDx-Melanoma test results who did not undergo SLNB have high recurrence-free survival (RFS) (three-year recurrence free survival rate of 99.5%) 3-year RFS (95% CI) Recurrence, % (n/N) 99.5% (98.7-100%) 0.5% (2/367) <5% risk of SLN positivity b
Slide 10: Evidence from prospective studies supporting DecisionDx-Melanoma
©2025 Castle Biosciences 10 Evidence from prospective studies supporting DecisionDx-Melanoma demonstrates: DecisionDx- Melanoma low-risk, Class 1A patients who forego an SLNB have high recurrence-free survival DecisionDx- Melanoma low-risk test results are associated with very low SLNB positive outc
Slide 11: DecisionDx-SCC Has Consistently Demonstrated High Value for Patients
©2025 Castle Biosciences 11 DecisionDx-SCC Has Consistently Demonstrated High Value for Patients in Guiding SCC Treatment Pathways DecisionDx-SCC launched commercially 2020 2021 2022 2023 2024 Number of peer-reviewed publications 1 2 4 5 4 Somani et al. – Integrating DecisionDx-SCC to guide ART deci
Slide 12: Drive robust test report volume and revenue growth
©2025 Castle Biosciences 12 Drive robust test report volume and revenue growth $59.3 $68.8 $65.1 $63.8 $63.0 $13.6 $18.2 $20.7 $22.5 $25.0 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q1 2025 Dermatologic Non-Dermatologic $87.0 $73.0 $85.8 $86.3 $88.0 NET REVENUE BY QUARTER ($M) Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q
Slide 13: Maintain strong Adjusted Gross Margin
©2025 Castle Biosciences 13 Maintain strong Adjusted Gross Margin 80.5% 83.2% 81.9% 81.1% 81.2% Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q1 2025 ADJUSTED GROSS MARGIN BY QUARTER1,2 $13.9 $14.5 $15.6 $16.2 $16.4 $13.8 $14.1 $12.3 $11.8 $12.6 $48.5 $51.1 $50.5 $50.0 $58.6 $2.2 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q
Slide 14: Improving operating cash flow and Adjusted EBITDA
©2025 Castle Biosciences 14 Improving operating cash flow and Adjusted EBITDA $(6.8) $24.0 $23.3 $24.4 $(6.0) Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q1 2025 OPERATING CASH FLOW BY QUARTER ($M) 1. As of March 31, 2025; includes Cash, Cash Equivalents & Marketable Investment Securities 2. Net cash used in op
Slide 15: Appendix
©2025 Castle Biosciences 15 Appendix
Slide 16: DecisionDx-Melanoma
©2025 Castle Biosciences 16 DecisionDx-Melanoma DERMATOLOGY Provides comprehensive, personalized, genomic tumor information to guide management for patients with cutaneous melanoma demonstrated change in management for 1 of 2 patients tested3 ~200,000 patients with a clinical DecisionDx- Melanoma or
Slide 17: DecisionDx-SCC
©2025 Castle Biosciences 17 DecisionDx-SCC DERMATOLOGY Identifies the risk of metastasis in patients with squamous cell carcinoma (SCC) and one or more risk factors Clinical Validity and Utility Demonstrated validity, utility and impact, backed by 22 peer-reviewed publications, including data showin
Slide 18: MyPath Melanoma
©2025 Castle Biosciences 18 MyPath Melanoma DERMATOLOGY Aids in the diagnosis and management for patients with ambiguous melanocytic lesions Clinical Validity and Utility Demonstrated validity, utility and impact, backed by 20 peer-reviewed publications demonstrating the performance and utility of t
Slide 19: TissueCypher
©2025 Castle Biosciences 19 TissueCypher GASTROENTEROLOGY A leading risk-stratification test designed to predict risk of progression to esophageal cancer in patients with Barrett’s esophagus Clinical Validity and Utility Demonstrated validity, utility and impact, backed by 16 peer-reviewed publicati
Slide 20: DecisionDx-UM
©2025 Castle Biosciences 20 DecisionDx-UM OPHTHALMOLOGY The standard of care for evaluating metastatic risk in uveal melanoma Standard of Care • Utilized in approximately 80% of newly diagnosed patients • Favorable reimbursement profile – covered by Medicare and more than 100 private insurers • Incl
Slide 21: Atopic Dermatitis Gene Expression Profile Test
©2025 Castle Biosciences 21 Atopic Dermatitis Gene Expression Profile Test PIPELINE Test currently in development for use in patients diagnosed with moderate-to-severe atopic dermatitis (AD) who are seeking systemic treatment • Pipeline test has shown potential to identify the class of therapy to wh
Slide 22: Reconciliation of Non-GAAP Financial Measures: Adjusted Revenues and Gross Margin
©2025 Castle Biosciences 22 Reconciliation of Non-GAAP Financial Measures (Unaudited) The table below presents the reconciliation of Adjusted Revenues and Adjusted Gross Margin, which are non-GAAP financial measures. See "Use of Non- GAAP Financial Measures (UNAUDITED)" above for further information
Slide 23: Reconciliation of Non-GAAP Financial Measures: Adjusted EBITDA
©2025 Castle Biosciences 23 Reconciliation of Non-GAAP Financial Measures (Unaudited) The table below presents the reconciliation of Adjusted EBITDA, which is a non-GAAP financial measure. See "Use of Non-GAAP Financial Measures (UNAUDITED)" above for further information regarding the Company's use
Slide 24: Thank You
©2025 Castle Biosciences 24 Thank You