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Castle Biosciences reported Q1 2026 results with net revenues of $83.7 million, down from $88.0 million a year earlier, as its dermatologic and gastroenterology diagnostics portfolio continued to drive sales. The company’s net loss narrowed to $14.5 million from $25.8 million, reflecting lower operating expenses, including a sharp reduction in amortization of acquired intangibles.
Cash and cash equivalents were $63.8 million and marketable investment securities were $197.9 million as of March 31, 2026, supporting management’s view that current resources and expected revenues can fund operations for at least the next 12 months. Test volume grew to 26,933 reports, driven by growth in DecisionDx-Melanoma and a 58% increase in TissueCypher usage, while operating cash outflows increased as the company invested in its expanding test portfolio and new facilities.
Castle Biosciences reported first-quarter 2026 results, with revenue of $83.7 million. Revenue declined from $88.0 million a year earlier, but core tests DecisionDx-Melanoma and TissueCypher grew volumes 16% and 58%, driving a 36% combined increase.
GAAP gross margin was 73%, with non-GAAP Adjusted Gross Margin of 75.6%. The company posted a net loss of $14.5 million and Adjusted EBITDA of $(5.1) million. Cash, cash equivalents and marketable securities totaled $261.7 million.
Castle raised its 2026 total revenue guidance to $345–355 million from $340–350 million, citing momentum in core tests and expanding clinical evidence across dermatology, gastroenterology and atopic dermatitis, including new data supporting DecisionDx-Melanoma, TissueCypher and AdvanceAD-Tx.
Entities associated with Castle Biosciences CEO Derek Maetzold reported open-market sales totaling 4,172 shares of Common Stock on April 21 at a weighted-average price of $25.098 per share. These transactions were made pursuant to a Rule 10b5-1 plan adopted on December 3, 2025.
The filing also shows Maetzold exercised stock options to acquire 550 shares at $2.39 per share and sold a matching 550 shares, leaving 21,479 shares held directly, plus additional indirect holdings in several family and grantor retained annuity trusts.
CASTLE BIOSCIENCES INC President & CEO Derek J. Maetzold reported an exercise-and-sell transaction in company stock. On April 6, 2026, he exercised stock options to acquire 6,214 shares of common stock at an exercise price of $2.39 per share, converting previously granted options into shares.
On the same date, Maetzold sold 6,214 directly held shares of common stock at a weighted-average price of about $25.03 per share, along with additional open-market sales through several family and estate-planning trusts totaling 9,836 shares sold overall. According to the filing, these sales were made under a Rule 10b5-1 trading plan adopted on December 3, 2025, indicating they were pre-scheduled rather than opportunistic trades.
After these transactions, Maetzold continues to hold 21,479 shares directly and maintains substantial indirect ownership through multiple trusts, including 48,852 shares in The Maetzold Descendants 2020 Trust and 85,959 shares in DJM Grantor Retained Annuity Trust No. 5, among other vehicles.
Castle Biosciences is asking stockholders to vote at its 2026 annual meeting on electing three Class I directors, ratifying KPMG as auditor, approving executive pay on an advisory basis and approving its non-employee director compensation policy.
Management highlights 2025 revenue of approximately $344 million, above guidance, driven by strong demand for DecisionDx-Melanoma and TissueCypher, whose test volumes rose 37% over 2024. The company reports about $300 million in cash, cash equivalents and marketable securities, an eight‑member largely independent, classified board, and governance features such as stock ownership guidelines, a clawback policy, prohibitions on hedging and pledging, and fully independent key committees.
Castle Biosciences (CSTL) President and CEO Derek J. Maetzold reported exercising stock options and selling shares in a pre-planned transaction. He exercised options for 550 shares of common stock at $2.39 per share, then sold a total of 4,172 common shares at a weighted-average price of $25.551 per share under a Rule 10b5-1 trading plan.
After these transactions, Maetzold holds 21,479 common shares directly and 13,732 options, with additional indirect holdings through several family trusts, including 50,209 shares in The Maetzold Descendants 2020 Trust and 42,673 shares in the Derek Maetzold 2020 Irrevocable Trust.
Castle Biosciences director Rodney Cotton exercised restricted stock units to receive common shares. On March 26, 2026, he exercised 5,329 Restricted Stock Units (RSUs), each representing one share of common stock, at an exercise price of $0.00 per share.
Following the transaction, his direct holdings of Castle Biosciences common stock increased to 19,331 shares. The RSUs relate to a prior grant of 15,988 RSUs awarded on March 26, 2024, which vest in three equal annual installments beginning March 26, 2025. This filing reflects a routine compensation-related equity vesting and exercise event, not an open‑market purchase or sale.
Derek Maetzold reported proposed sales of Common shares of CSTL under Rule 144, listing multiple transactions dated between 01/05/2026 and 03/18/2026.
The filing lists numerous individual dispositions by Mr. Maetzold and related trusts, with transaction entries showing share counts and dollar values for each trade, including a 23,179-share entry on 03/12/2026. The filing is a disclosure of proposed/resale transactions under Rule 144.
Castle Biosciences Inc ownership update: The Vanguard Group filed an amendment reporting it beneficially owns 0 shares (0%) of Castle Biosciences common stock as disclosed in this Schedule 13G/A.
The filing explains an internal realignment of Vanguard subsidiaries that resulted in disaggregated reporting under SEC Release No. 34-39538. The filing is signed by Ashley Grim, Head of Global Fund Administration.