On December 9 2025, Castle Biosciences announced that a panel of ten melanoma experts published a consensus paper endorsing its DecisionDx‑Melanoma gene‑expression profiling test as a best‑practice tool for managing cutaneous melanoma. The panel reviewed 26 studies involving more than 7,500 patients and reached unanimous agreement that the test provides prognostic information independent of traditional clinicopathologic factors.
The endorsement confirms that DecisionDx‑Melanoma can be integrated with existing staging systems to improve risk assessment and guide sentinel lymph node biopsy decisions and long‑term surveillance. By delivering independent prognostic data, the test helps clinicians tailor treatment plans and potentially improve patient outcomes.
The endorsement strengthens Castle’s market position and supports ongoing payer negotiations. It is expected to accelerate adoption by dermatologists and oncologists, driving higher test volumes. In Q3 2025, Castle reported revenue of $83.0 million, a slight decline from $85.8 million in Q3 2024, but the nine‑month total of $257.2 million rose from $245.8 million year‑over‑year. Core dermatology and gastroenterology segments each surpassed 10,000 test reports for the first time, with DecisionDx‑Melanoma delivering 10,459 reports, a 12% year‑over‑year increase.
President and CEO Derek Maetzold said the consensus “translates the robust data supporting DecisionDx‑Melanoma into practical direction for clinicians” and highlighted the test’s role in personalized care. He also noted that the company’s momentum reflects the strength of its core testing franchises and that the new endorsement will help solidify payer coverage and market share.
Castle raised its full‑year 2025 revenue guidance to $327–$335 million from $310–$320 million, reflecting confidence in continued demand for its core tests. Gross margin compression to 75% from 79% in Q3 2024 is attributed to pricing pressure and a shift in product mix, but the company remains focused on scaling its high‑margin dermatology and gastroenterology offerings while investing in new products such as AdvanceAD‑Tx.
The competitive landscape for melanoma prognostic testing includes a few other assays, but Castle differentiates itself through extensive independent validation, integration with staging systems, and a growing payer network that supports widespread adoption.
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