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Castle Biosciences Inc

Castle Biosciences Inc

CSTL
$24.16USD↓-0.29%-0.07 today

MARKET CAP

732.8M

P/E (TTM)

—

FWD P/E

—

DAY RANGE

$24 – $24

52W RANGE

$15
$44

AI Summary

Stalk
Buy NowMedium

CSTL remains in a Stage 2 Advancing corrective reset with an active Lockout Rally driving upside urgency. The medium-term bias is bullish, supported by a clear HH/HL sequence and price holding above rising 9/20 EMAs. Despite overbought conditions, the Lockout Rally override justifies immediate participation. Optimal entries target shallow pullbacks into the 9/20 EMA zone. Key risks include failure to hold EMA support, a decisive break below the 50DMA, or rejection at the overhead 200DMA.

  • ↑Q1 2026 revenue reached $83.7 M, rising 42% YoY
  • ↑DecisionDx melanoma and TissueCypher test volumes grew 36% YoY
  • ↓Q1 2026 net loss was $14.5 M; adjusted gross margin down to 75.6%
Full analysis →

The case for & against

Bull & Bear analysis

Bullish

Castle Biosciences, Inc. (NASDAQ: CSTL) specializes in developing and commercializing diagnostic tests supporting decision-making in cancer management. Its primary products are the DecisionDx suite, targeting melanoma and other cancers, and the recently launched TissueCypher, which focuses on gastrointestinal conditions. The company is positioned within the growing market for precision medicine, emphasizing personalized treatment to enhance patient outcomes. Castle's innovative approach to diagnostics places it at the forefront of oncology testing, exhibiting strong growth prospects amidst competitive pressures.

Bull says

  • ↑Q1 2026 revenue reached $83.7 M, rising 42% YoY
  • ↑DecisionDx melanoma and TissueCypher test volumes grew 36% YoY
  • ↑Advanced ADTX saw 650 orders in Q1, indicating strong adoption
  • ↑Cash reserves of $261.7 M support R&D and expansion plans
  • ↑2026 revenue guidance raised to $345–355 M
  • ↑High institutional ownership and positive growth momentum

Bear says

  • ↓Q1 2026 net loss was $14.5 M; adjusted gross margin down to 75.6%
  • ↓Operating expenses rose to $115.9 M, straining profitability
  • ↓Pending reimbursement for DecisionDx SCC may cause revenue swings
  • ↓Intense competition and pricing pressure could erode margins
  • ↓Negative earnings yield and high short interest suggest valuation risk
  • ↓High leverage and stock volatility amplify downside vulnerability

Investment themes with CSTL

Health Care Providers↓ -0.61%

UNH · CVS · HCA

Earnings Call · Q1 2026 · Mgmt. Guidance

Updated 05-10-2026neutral

Transcript signals

Bull points

  • 2026 total revenue
  • We delivered strong first quarter results, building on our momentum from 2025. Thanks to the strong execution by the entire CASEL team, we delivered revenue of $83.7 million.
  • Test report volumes for our core revenue drivers grew 36% compared to the first quarter of 2025. Excluding decision DXSCC and ID genetics revenue, our revenue growth for the first quarter of 2026 is approximately 42% compared to the first quarter of 2025, highlighted by double-digit year-over-year test report volume growth for both decision DX melanoma and tissue cipher.

Bear points

  • we aren't at this point in time thinking that there is a later posting of a draft LCD than sort of the second half of this year. That would be surprising.
  • volumes did decline very modestly quarter over quarter
  • Adjusted EBITDA for the first quarter was negative $5.1 million compared to $13 million for the comparable period in 2025.
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