Castle Biosciences, Inc. Common Stock 2026 Global Healthcare Conference

Maybe I'll talk about the business top line, and you can cover- Sure specific on financials.

Castle Biosciences is a molecular diagnostics company. We have a number of tests on the marketplace that we've demonstrated not only are impacting decisions physicians make, but also improving outcomes. Either lives are extended or we're doing less uncertain things that'll make a difference. We focus on two main areas therapeutically or customer-wise, I would say. We have a dermatology sort of commercial and R&D vertical. We have a number of tests in there for our DecisionDx-Melanoma test, our AdvanceAD-Tx test, for directing therapy for atopic dermatitis, our squamous cell carcinoma test. On the gastroenterology side, which is our other vertical, we have one test currently on the market there, which is TissueCypher, which is used in Barrett's esophagus disease to help direct care in that patient population.

I think we had certainly a good quarter. I think our two main revenue drivers, our melanoma test, our TissueCypher test, we saw good progress there. I think on TissueCypher, I would encourage sort of looking at a four-quarter kind of rolling growth trend. We're still fairly early in that launch, and that volume number is becoming more predictable but still is not quite as easy to project with perfect precision just given where we are in the launch. But we had good, strong, adjusted gross margins, among the best in the sector, and that gives us lots of room down the P&L to invest in R&D and other activities for the company.

No. No. I think macro environment is largely the same.

I think that it is important for folks to remember that inflation is still fairly durable. When you look at operating expenses and things like that, it is important to recall that 4.5% up is flat. Even when inflation eases, unfortunately, prices do not go down, they just go up Yep less quickly.

So, inflation is still durable. I think maybe early in the year we were thinking or hoping we would see a little bit of ease there, but certainly still intact.

I would probably break that down into a couple slightly different approaches.

Yeah. I think the growth in endoscopic procedures is a good macro level.

We do not necessarily track that on a daily basis. That does not affect our business that much, you would say. But in terms of the number of patients diagnosed with Barrett's esophagus each year, we think the addressable market for us is around 415,000 patients who have either non-dysplastic disease, indefinite disease, or low-grade dysplasia, which are all in the target universe of TissueCypher. So, a nice, big, consistent population. Post-COVID, we have certainly seen some growth in overall annual endoscopic procedures, but I think that is a nice trend to have. In terms of TissueCypher growth, based upon the 2Q performance, we, I guess you would say, increased our overall volume expectations to somewhere between 50%-52% year-over-year growth in volume, which is an excellent Yep growth product for us and just shows you what the demand is for this test, which really is helping to direct what is this patient with Barrett's esophagus disease, what is the right pathway for from a treatment standpoint.

Yeah. In terms of penetration within sort of marketplaces, we are still early in the launch curve.

We are still capturing a large number of new first-time ordering prescribing clinicians or gastroenterologists. I would not call those late adopters. I think it is middle-of-the-road people right now. The second tier up is sort of current customers. Can we increase penetration current customers? Our sense right now is that if a gastroenterologist is going to make the decision that he wants to or she wants to incorporate TissueCypher test results in the care of a patient with Barrett's esophagus disease, it is awfully hard to go ahead and slice and dice that patient population. They sort of all have the same pathology. Some might have different risk factors than others. But the risk factor projections on progression likelihood are so soft that it is almost a all or none.