Castle Biosciences, Inc. · NASDAQ:CSTL
Castle Biosciences — Q4 2024 Earnings Presentation
26 slides from Castle Biosciences's earnings presentation, Feb 27, 2025
Slide 1: Empowering people, informing care decisions - Fourth Quarter 2024
Empowering people, informing care decisions Fourth Quarter 2024 February 27, 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: 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 6: Key 2024 and recent results
Key 2024 and recent results Findings from a prospective, multicenter study demonstrating the significant impact of the DecisionDx-Melanoma test on sentinel lymph node biopsy (SLNB) decision-making for patients with melanoma were 1 published in the World Journal of Surgical Oncology, further no patie
Slide 7: DecisionDx-Melanoma CONNECTION study predicts low risk of SLN positivity
Data from the DecisionDx-Melanoma prospective, multicenter CONNECTION study was successful at predicting which BUILD patients with T1 tumors have a low risk of SLN positivity DecisionDx-Melanoma correctly identified a population of patients with very low risk of SLN positivity who could have avoided
Slide 8: Low-risk patients who did not undergo SLNB have high recurrence-free survival
Patients with low-risk DecisionDx-Melanoma test results who did not undergo SLNB have high recurrence-free survival (RFS) BUILD (three-year recurrence free survival rate of 99.5%) RFS in patients with <5% risk (DecisionDx- Melanoma) who did not undergo SLNB Survival Probability 3-year RFS Recurrence
Slide 9: 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 10: DecisionDx-SCC guiding SCC treatment pathways
DecisionDx-SCC Has Consistently Demonstrated High BUILD Value Patients in Guiding SCC Treatment Pathways 2019 2020 2021 2022 2023 2024 1 2 4 5 4 6 Number of peer-reviewed Study Demonstrating Risk Stratification Studies Demonstrating Predictive Value of ART publications Value in High-Risk SCC in High
Slide 11: 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 $53.3 Q4 2023 Q1 2024 Q2 2024 Q3 2024 Q4 2024 Q4 2023 Q1 2024 Q2 2024
Slide 12: Maintain strong Adjusted Gross Margin
Maintain strong Adjusted Gross Margin ADJUSTED GROSS MARGIN BY QUARTER1,2 OPERATING EXPENSES BY QUARTER ($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 13: 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 14: Appendix
Appendix ©2025 Castle Biosciences 14
Slide 15: 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 16: 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 17: 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 18: 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 19: 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 20: 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 21: 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 22: Reconciliation of Non-GAAP Financial Measures (Unaudited)
Reconciliation of Non-GAAP Financial Measures (Unaudited) The tables 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 regarding the Company's use
Slide 23: 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 Twelve months e
Slide 24: 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 25: 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 26: Thank You
Thank You ©2025 Castle Biosciences 26