Castle Biosciences Stock Price, News & Analysis

Castle Biosciences (Nasdaq: CSTL) announced that on Dec. 15, 2025 its Compensation Committee granted restricted stock units to 83 employees covering an aggregate of 139,494 shares as inducements for entering employment.

The grants were made under the company’s 2022 Inducement Plan in accordance with Nasdaq Listing Rule 5635(c)(4). The RSUs vest over four years: 25% on the first anniversary of each applicable vesting commencement date, then the remaining shares vest annually in three equal installments, subject to continued service through each vesting date.

Castle Biosciences (Nasdaq: CSTL) reported new data from the largest prospective, multicenter study comparing NGS-based mutation analysis with the combination of DecisionDx-UM + PRAME for predicting outcomes in uveal melanoma (UM). Published Dec. 17, 2025, the COOG study analyzed 1,140 primary UM tumors and found that DecisionDx-UM + PRAME provided superior predictions of metastasis-free survival (MFS) and overall survival (OS) versus individual NGS mutation analysis. BAP1, SF3B1 and EIF1AX mutations lost independent predictive significance when DecisionDx-UM + PRAME were included in multivariate models. Castle offers DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq from one biopsy to support risk stratification and treatment planning.

Castle Biosciences (Nasdaq: CSTL) announced a December 12, 2025 systematic review and meta-analysis in Journal of Clinical Gastroenterology showing the TissueCypher Barrett’s Esophagus test provides validated risk stratification versus pathology or clinical factors alone.

The SRMA pooled six published studies and found high-risk TissueCypher results were 6.7x more likely to progress to high-grade dysplasia or esophageal adenocarcinoma within five years (p<0.0001). Annual progression rates were 5.6% for high-risk and 2.8% for high/intermediate-risk, both above a 1.7% LGD benchmark.

Castle Biosciences (Nasdaq: CSTL) announced an independent expert consensus paper published Dec 9, 2025 endorsing DecisionDx-Melanoma as a best-practice prognostic tool for cutaneous melanoma.

The paper—authored by ten melanoma experts after reviewing 26 studies covering >7,500 patients—reached unanimous agreement on nine statements: DecisionDx-Melanoma provides prognostic information independent of clinicopathologic factors, complements AJCC8 staging, guides sentinel lymph node biopsy (SLNB) decisions in T1b–T3 tumors, informs management of SLNB-negative patients, and is associated with improved melanoma-specific and overall survival versus untested patients.

Castle Biosciences (Nasdaq: CSTL) announced it was named a Houston Chronicle Top Workplace on Nov 17, 2025, marking the fifth consecutive year the company has earned the Houston metro designation.

Castle also received three national Top Workplaces Culture Excellence awards for Employee Appreciation, Employee Well-Being and Professional Development. The company said it has more than doubled its workforce since first earning the Top Workplaces recognition in 2021 and received a total of 13 Top Workplaces awards so far in 2025, including Top Workplaces USA and industry- and regional recognitions.

Castle Biosciences (Nasdaq: CSTL) reported new data showing its DecisionDx-Melanoma test improves sentinel lymph node biopsy (SLNB) decision-making and recurrence risk prediction in cutaneous melanoma. Two oral presentations will occur at ECDO on Nov 17–18, 2025.

The i31-SLNB algorithm outperformed the MIA nomogram (AUC=0.74 vs. 0.61; p=0.001), identifying a 2.6% actual SLN positivity rate for patients predicted <5% risk versus 5.8% by MIA. In a multicenter study of 810 SLN-negative patients, the 31-GEP independently predicted poorer five-year outcomes (Class 2B vs others; p<0.001) and improved prognostic accuracy when added to AJCC staging (ANOVA χ²=7.75, p=0.02).

Castle Biosciences (NASDAQ: CSTL) said its executive management will present a company overview at the Piper Sandler 37th Annual Healthcare Conference on Tuesday, Dec. 2, 2025 at 1:10 p.m. ET. A live audio webcast will be available at the company’s investor events page and a replay will be posted after the live broadcast.

Castle Biosciences (Nasdaq: CSTL) reported Q3 2025 revenue of $83.0 million and delivered 26,841 total test reports. The company raised full‑year 2025 revenue guidance to $327–335 million from $310–320 million and launched AdvanceAD‑Tx, a 487‑gene expression test for systemic treatment decisions in moderate‑to‑severe atopic dermatitis (ages 12+).

Core test volumes grew: DecisionDx‑Melanoma 10,459 and TissueCypher 10,609 reports in Q3; core revenue drivers test reports increased 36% year‑over‑year. The Novitas LCD excluding DecisionDx‑SCC (effective April 24, 2025) and discontinuation of IDgenetix affected revenue and volumes.

Castle Biosciences (Nasdaq: CSTL) launched AdvanceAD-Tx on November 3, 2025, a 487-gene expression profile test to guide systemic treatment choice for patients aged 12+ with moderate-to-severe atopic dermatitis.

Validation data showed 30.4% of samples had a JAK inhibitor responder profile; those treated with JAKi reached EASI-90 by three months at 45.5% vs 8.3% (p=0.021), had higher vIGA-AD clear rates (36.4% vs 0%, p=0.006), more “no itch” reports (45.5% vs 8.3%, p=0.021), and remained flare-free more often (54.5% vs 16.7%, p=0.041).

Castle estimates a U.S. TAM of $33 billion, is pursuing reimbursement pathways, and is beginning a measured limited-access commercial launch in November 2025 with phased expansion through 2026.