Castle Biosciences, Inc. · NASDAQ:CSTL
Castle Biosciences — Q4 2024 Earnings Presentation
31 slides from Castle Biosciences's earnings presentation, Feb 27, 2025
Slide 1: Empowering people, informing care decisions
Empowering people, informing care decisions February 2025 ©2025 Castle Biosciences 1
Slide 2: Disclaimers: Forward-Looking Statements
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 sectio
Slide 3: Disclaimers: Non-GAAP Financial Measures
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 accounting principles in the Uni
Slide 4: Registered Trademarks
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. ©2025 Castle Biosciences 4
Slide 5: Improving health through innovative tests that guide patient care
OUR MISSION Improving health through innovative tests that guide patient care OUR VISION Transforming disease management by keeping people first: patients, clinicians, employees, and investors ©2025 Castle Biosciences 5
Slide 6: Answering Clinical Questions To Guide Care Along The Patient Journey
Answering Clinical Questions To Guide Care Along The Patient Journey Our focus is on diagnostic support, risk stratification and therapy selection/response areas of the patient care continuum Therapy Diagnostic Selection/ PATIENT CARE JOURNEY Risk Stratification Support Response Dermatology Atopic D
Slide 7: Proven strategy designed to drive value creation for our stakeholders
Proven strategy designed to drive value creation for our stakeholders BUILD robust clinical FOCUS evidence on best/first-in-class tests with high, unmet clinical need and significant market opportunity PENETRATE target markets to further test adoption by clinicians and payers ©2025 Castle Bioscience
Slide 8: Building evidence showing the value of our tests
Building evidence showing the value of our tests BUILD Data from our Studies2 demonstrating prospective, multicenter that our test can Ablation has been Randomized DECIDE study show use improve risk shown to stop controlled of DecisionDx- stratification when used progression to EAC study shows Melan
Slide 9: DecisionDx-Melanoma provides precise, personalized risk prediction
DecisionDx-Melanoma provides precise, personalized risk prediction for two critical clinical questions BUILD Collaborative study with the National Cancer Institute’s SEER Program Registries is the largest real- Clinical use of DecisionDx-Melanoma is associated with improved patient survival world st
Slide 10: DecisionDx-Melanoma improves risk stratification in stage I melanoma versus AJCC staging
DecisionDx-Melanoma significantly improves risk stratification in stage I melanoma BUILD compared to AJCC staging DecisionDx-Melanoma was compared to American Joint Committee on Cancer Staging Manual 8th Edition (AJCC8) COHORT 1 – Combined staging for stage I cutaneous melanoma Combined cohort of st
Slide 11: Evidence from prospective studies supporting DecisionDx-Melanoma
Evidence from prospective studies supporting BUILD DecisionDx-Melanoma demonstrates: 1 2 3 Physicians are using DecisionDx- DecisionDx- DecisionDx-Melanoma Melanoma low-risk Melanoma low-risk, to inform clinical test results are Class 1A patients decisions about associated with who forego an sentine
Slide 12: DecisionDx-SCC addresses two critical clinical questions
DecisionDx®-SCC addresses two critical clinical BUILD questions 1 2 What is this SCC patient’s Is this SCC patient likely risk of regional or distant to benefit from adjuvant metastasis? radiation therapy (ART)? Overall Event Rate: 13.2%, n=897 Class 1 Class 2A Class 2B Class 1 Class 2A Class 2B Low
Slide 13: DecisionDx-SCC identifies patients who benefit most from ART
DecisionDx-SCC identifies patients who benefit most BUILD from ART to control metastatic disease progression noART: Class 2B ART: Class 2B MEDIAN RISK OF METASTATIC DISEASE PROGRESSION 100 ART: Class 2A • A Class 1 or Class 2A result did not 1.00 noART: Class 2A reflect a significant decrease in MED
Slide 14: Advancing penetration of our tests with clinicians and payers
Advancing penetration of our tests with clinicians and payers PENETRATE Expert Consensus & Reimbursement Castle Commercial Guidelines1 Strategy Playbook Total Test Report Volume • DecisionDx-Melanoma: 2023 • Increased total number of ADLTs National Society for Cutaneous to 5 by obtaining approval fr
Slide 15: Financials
Financials ©2025 Castle Biosciences 15
Slide 16: Well positioned for continued value creation
Well positioned for continued value creation Drive robust test volume growth Maintain strong Adjusted Gross Margin Goal to achieve operating cash flow positivity by the end of 2025 Maintain strong balance sheet Follow disciplined capital allocation ©2025 Castle Biosciences 16
Slide 17: Drive robust test report volume and revenue growth
Drive robust test report volume and revenue growth NET REVENUE BY QUARTER ($M) TOTAL TEST VOLUME BY QUARTER 26,010 25,102 $87.0 $85.8 $86.3 24,0713,4 $18.2 20,284 20,888 $73.0 $20.7 $22.5 $66.1 $13.6 $12.8 $68.8 $65.1 $63.8 $59.3 $53.3 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q4 2023 Q1 2024 Q2 2024
Slide 18: Maintain strong Adjusted Gross Margin
Maintain strong Adjusted Gross Margin ADJUSTED GROSS MARGIN BY QUARTER1,2 OPERATING EXPENSES BY QUARTER ($M)3 $2.2 $4.3 $2.2 $2.3 $2.3 $51.1 $50.5 $50.0 $48.5 $44.1 82.3% 80.5% 83.2% 81.9% 81.1% $13.8 $14.1 $12.3 $11.8 $13.0 $12.4 $13.9 $14.5 $15.6 $16.2 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q4 20
Slide 19: Improving operating cash flow and Adjusted EBITDA
Improving operating cash flow and Adjusted EBITDA Cash position of ~$293M1 supports growth initiatives OPERATING CASH FLOW BY QUARTER ($M) ADJUSTED EBITDA BY QUARTER ($M)3,4 $24.0 $24.4 $21.5 $21.6 $21.3 $23.3 $18.6 $10.5 $9.4 $(6.8) Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q4 2023 Q1 2024 Q2 2024 Q3
Slide 20: A disciplined approach to capital allocation
A disciplined approach to capital allocation Commercial optimization Focused R&D efforts to build evidentiary support and develop tests As a lesser priority, strategic opportunities, including within our current therapeutic areas ©2025 Castle Biosciences 20
Slide 21: Appendix
Appendix ©2025 Castle Biosciences 21 21
Slide 22: DecisionDx-Melanoma
DERMATOLOGY DecisionDx-Melanoma Provides comprehensive, personalized, genomic tumor information to guide management for patients with cutaneous melanoma Clinical Validity, Utility and SLNB Guidance and Demonstrated Patient Patient Outcomes1,2 Outcomes DecisionDx-Melanoma Demonstrated clinical succes
Slide 23: DecisionDx-SCC
DERMATOLOGY DecisionDx-SCC Identifies the risk of metastasis in patients with squamous cell carcinoma (SCC) and one or more risk factors Clinical Validity and Utility Real-World Use Framework Demonstrated validity, Study in Clinical, Cosmetic utility and impact, backed and Investigational ~200,000 ~
Slide 24: MyPath Melanoma
DERMATOLOGY MyPath Melanoma Aids in the diagnosis and management for patients with ambiguous melanocytic lesions Clinical Validity and Utility Guideline Support Demonstrated validity, • National Comprehensive utility and impact, backed Cancer Network guidelines by 20 peer-reviewed publications demon
Slide 25: TissueCypher
GASTROENTEROLOGY TissueCypher A leading risk-stratification test designed to predict risk of progression to esophageal cancer in patients with Barrett’s esophagus Clinical Validity and Utility Recognition from AGA Demonstrated validity, 2024 Clinical Practice Guideline utility and impact, backed ack
Slide 26: IDgenetix
MENTAL HEALTH IDgenetix Advanced pharmacogenomic (PGx) test designed to guide medication selection and management for patients with neuropsychiatric conditions, such as depression and anxiety Advanced PGx Easy to Use • Demonstrated clinical • 10 mental health and validity, utility and impact, backed
Slide 27: DecisionDx-UM
OPHTHALMOLOGY DecisionDx-UM The standard of care for evaluating metastatic risk in uveal melanoma Clinical Validity and Utility Standard of Care Demonstrated validity, • Utilized in approximately utility and impact, backed 80% of newly diagnosed by 27 peer-reviewed patients publications, which • Fav
Slide 28: Atopic Dermatitis Gene Expression Profile Test
PIPELINE Atopic Dermatitis Pipeline Program Atopic Dermatitis Gene Expression Profile Test 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 • Data from our ongoing potential to iden
Slide 29: Reconciliation of Non-GAAP Financial Measures (Unaudited)
Reconciliation of Non-GAAP Financial Measures (Unaudited) The tables below present the reconciliation of Adjusted Revenues and Adjusted Gross Margin, which are non-GAAP financial measures. See disclaimer slide for further information regarding the Company’s use of non-GAAP financial measures. Three
Slide 30: Reconciliation of Non-GAAP Financial Measures (Unaudited)
Reconciliation of Non-GAAP Financial Measures (Unaudited) The table below presents the reconciliation of Adjusted EBITDA, which is a non-GAAP financial measure. See disclaimer slide for further information regarding the Company’s use of non-GAAP financial measures. Three months ended Dec. 31, Sep. 3
Slide 31: Thank You
Thank You ©2025 Castle Biosciences 31