Castle Biosciences published a systematic review and meta‑analysis in the Journal of Clinical Gastroenterology that consolidates data from six studies and confirms that its TissueCypher Barrett’s Esophagus test outperforms traditional pathology and clinical factors in predicting progression to high‑grade dysplasia or esophageal adenocarcinoma.
The analysis shows that patients with high‑risk TissueCypher results are 6.7 times more likely to progress within five years, with annual progression rates of 5.6% for high‑risk patients and 2.8% for high/intermediate‑risk patients, compared with 1.7% for low‑grade dysplasia. The spatial‑omics‑based risk assessment enables clinicians to tailor surveillance schedules, potentially reducing unnecessary procedures and improving patient outcomes.
The validation supports Castle’s strategy to expand beyond dermatology into high‑margin specialty diagnostics. In Q3 2025, the company reported revenue of $83.0 million, a slight decline from $85.8 million in the same period a year earlier, while total test reports rose to 26,841 from 26,010. Gross margin fell to 75% from 79%, but non‑dermatologic revenue grew 67% YoY, reflecting momentum in the gastrointestinal segment. CEO Derek Maetzold highlighted that DecisionDx‑Melanoma and TissueCypher each surpassed 10,000 test reports in a single quarter, underscoring growing adoption of the core tests.
Analyst coverage reflected the positive impact of the publication. BTIG’s Mark Massaro increased his price target for Castle to $50.00 from $38.00, citing the robust evidence base for TissueCypher as a key driver of future growth and reimbursement potential.
The meta‑analysis strengthens Castle’s clinical credibility and positions the company to secure favorable reimbursement, accelerate market penetration, and drive long‑term revenue growth in the gastrointestinal diagnostics space.
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