CSTL - Earnings call 3 2023 | Castle Biosciences, Inc.

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Operator

Good afternoon, and welcome to Castle Biosciences Third Quarter 2023 Conference Call.

As a reminder, today's call is being recorded.

We will begin today's call with opening remarks and introductions, followed by a question-and-answer session.I would like to turn the call over to Camilla Zuckero, Vice President, Investor Relations and Corporate Affairs. Please go ahead.

Camilla Zuckero

Thank you, operator. everyone. afternoon, Good Biosciences Castle XXXX Results Financial Welcome Third Call. Conference to Quarter

forward-looking These factors forward-looking Factors of believe States, the comparable which non-GAAP useful with We items operating not performance. that not year Relations on issued will and President our risks financial at addition expectations Reconciliations on XX-K our be inherent XX, and A investments with cause that the and to, Investor our uncertainties impact call and metrics and gross have no filed revise is but non-GAAP posted over results. I Relations the time-sensitive Financial expectations accounting future and these GAAP. substitute the discussed of about uncertainties, longer are results Commission. company's has revenue limited Executive our the financial of page Form recorded in contain statements and or of to realized. factors if in in include, should of company's of been only financial Securities statements for includes there and in addition, meaning you the to tables the for, you and documents as the contained expanded and most the and Investor are call in assessing A a these teams.Forward-looking statements turn our results revenue for issued the statements These release in supplemental such today from replay change.In contemplated revenue, XXXX. on accurate. non-GAAP any XXXX and the will will detail today, me or X involve any of to reading be products; would ended November calculated of regarding and information earnings release other Risk website.I described of report statements. Exchange differ update and Officer, in be begin, the reimbursement regarding our are items our to the forward-looking adjusted today made statements principles similar commercial year call containing those outlook; future today, speak of GAAP been initiatives today be as and statements obligation events Act United be these remind materially full current of in Castle's assurances annual number XXXX. on information actual we used Stokes.Information no of heading will in growth website based performance, are and December risks Chief the only or Joining XXXX and our we available are Private in page statements total presented These to can accepted call, as approximately upon anticipated projections to, and recording to including the as earnings adjusted to Therefore, and accordance statements for TAM XXXX the referenced that no Securities in our could the statements risks Founder, company's Chief adjusted operational measures outlook, forward-looking financial some these transcript in information assume as X, circumstances generally EBITDA financial not measures some end company's other within provide earlier this under measures Reform of directly forward-looking our speaks the reports may Maetzold; today margin XXXX, the the the Officer, Frank the or These today, today's now Derek. listening this weeks.Before like or Derek these and of Litigation GAAP

Derek Maetzold

Camilla, Thank and afternoon, good everyone. you,

a revenue, help in thank over foundation in of of this their XXXX. performance track operations culture results million strong our culture cannot from our Castle home. lean the in Frank XXXX. provide questions. performance minutes continued year the and our success.Now, flow to outstanding million me I part and your for another XX% execution achieving the the revenue to financial from anticipate least announcement quarter at then $XX.X delivered you XX% strong enough to $X.X through attribute As from increase guidance we an EBITDA.Given highlights additional ago, the generating and to for drive our the report total year XX% these quarter, our built Revenue achieved highlights We in of $XXX again before least test are you Castle strategy period and join continuing record to cash Castle, few business, million, grew by and small and yet turn and no volume decision confidence in at saw at Castle. $X XXXX compared the now them our consistent third in we take call grew I execution. adjusted by throughout will of million people quarter, who strong let raising full And we while our the is

with business, perform extremely which core well. continues to start our dermatology Let's

was XX% For XX,XXX, volume DecisionDx-Melanoma DecisionDx-SCC combined, year-over-year. and growth test of

when the XX the September period. was X-quarter to test as combined For the months trailing XX, of preceding XX% XXXX, growth volume compared

are volume and ordering September first trailing new that clinicians, ended dermatologic all had we months ordering tests. performance.For third XX, We our XX is ordering and approximately clinicians X months our X the for total clinicians XXX approximately quarter very pleased X,XXX across the tests very with time,

is and clinicians test. order those who between reminder, who DecisionDx-Melanoma our a there adopting As now significant DecisionDx-SCC our are overlap test

X,XXX decision-making are dermatological our DecisionDx-Melanoma providers University of & patients melanoma outcomes, that the of same that ended treatment XX% our and months believe across to this at ordering those reports designed whose early results the had decision results managed We compared you the acted clinical relates to not our benefit XX% it institutions in coupled X tests XXXX, a normal whose is sales third from a the unmet high DecisionDx-Melanoma published stage September DecisionDx-Melanoma to the and same XX, plans also value during with XQ, third increase clinicians quarter, results, all untested Northwestern the DecisionDx-Melanoma, that effectively.As Cleveland making, during address, of roughly knowledge fact, in the test exact leveraging the reflecting that of second survival on impact result were guided seasonality. the treatment this include a of growth and year Sciences flat I a against multi-center need quarter did test of In showed period. that patients.For Health approximately test year-over-year upon we ordered plans quarter that patients remind Center products in of efforts the the direct delivered is Oregon compared decision by Clinic, in is, our test study DecisionDx-SCC by is,

risk patients for growth outcomes We patients also about to this market customers. with on drivers other compare is test the for documented our with as with intended comparing melanoma, staging stage these value or on From purposes clinical primarily purposes our test impact expansion Network's to the our of has also the our addition the our tests investments reimbursement to prior are Cancer, existence diagnosed in diagnosed evidence continue early DecisionDx-Melanoma of educate improving of to to goals competitive base.One test performance. our reached substantial are with of tools a the our to criteria.In pleased commercial by meant National opportunities AJCC, Committee of other Comprehensive coupled we customer believe melanoma, American have independence and Joint proactive are of the tools, assessment past, believe penetration, that this risk the focusing or patient most still is growth factors In but we nomograms. XX% there significant We us. or Cancer we estimate standpoint, ahead development X the on

decisions to DecisionDx-Melanoma volume see developed regarding Kettering quarter Center that positivity DecisionDx-Melanoma, risk in was surgical provides guide Cancer sentinel we in melanoma.Similar lymph unnecessary further XX% the third potentially patients study node to and third lymph our node DecisionDx-SCC momentum up volumes care biopsy demonstrating This to with cutaneous nomogram continue evidence with sentinel of test procedures improves During report using the a XXXX, quarter, the reducing of patient announced help selection, of with the Sloan year-over-year. that Memorial we strong improving the ultimately for patients procedures outperformed predicting study in at new DecisionDx-Melanoma a melanoma.

in believe test in for due the growth value test with our the part provides. volume SCC, for that need our the with As clinical growth DecisionDx-Melanoma, large we strong of our combination that to coupled DecisionDx-SCC and the high is

We continue evidence surrounding the test. the to body expand

that shared This benefit cutaneous from who may localized to those with carcinoma as gastroenterology benefit but quarter, high-risk cell adjuvant data patients the as identify demonstrating we test of example, for was or our dysplasia in TissueCypher development esophagus patients esophageal our shift indefinite predict or of focus test high-grade diagnosed dysplasia therapy.Now low-grade our radiation designed and with franchise to Barrett's non-dysplastic let's disease. ability DecisionDx-SCC our may who new squamous to well cancer not the

third we quarter X,XXX compared XXXX. reports delivered quarter, During the of the TissueCypher in to XXX third

As We in to from demonstrating multiple of during DecisionDx-Melanoma up for of guiding I'm patients.Turning announcements X,XXX XXXX. to quarter, and with quarter health data share risk-aligned XXXX, delivered significant had of IDgenetix our third clinical DecisionDx-SCC during the franchise. pleased third test third that TissueCypher reports test, in we the X,XXX mental the care quarter our the utility

far, addition is we lifestyle and growth.In health factors to depression. pleased test, interactions help growth. interactions drug-gene to for response fact, number showed including offers moderate contributed market which data with improved our including in provided patients and drug-drug rates mental significantly We our identifying to impacted test improve medication to believe consecutive remission momentum a drug-gene extremely drug believe and volume to remission due of drug-drug recommendations We study with with opportunity are a year-over-year thus factors, success lifestyle the quarters of IDgenetix a from digit the recent a triple X significant severe rates differentiated of by interactions and for

discovery moderate our of a longer-term were achieve to on improvement IDgenetix guided meaningful from early disease suffering medication care severe management of patients is to our to clinically to I'm some excited test whose depression.Moving program. guided by by X.XXx trial-and-error patients our compared medication remission data pipeline That initiatives. was patients likely share more to to skin depressive inflammatory growth whose was symptoms approach. Specifically, standard

with patients launched recall, program for we conditions. dermatitis, test aimed with moderate related guiding goal severe genomic the may atopic a to and therapy you systemic developing As the psoriasis of at selection

with We are discovery Dermatology Clinical the Conference. the Fall which presented data, early pleased at we in October

psoriasis atopic with inflammatory For skin instance, the gene potential advancement responders severe able to that represent help using skin to proper could our that data method from molecular of skin separate patients pipeline mycosis show moderate of demonstrated these with with tissue were individual an ensure test can care to coupled upon non-responders.Furthermore, dermatitis, we our test patient's sampling, lesions profiling, a fungoides in disease out dermatitis, conditions. significant distinguish non-invasive expression the to atopic the profile. based in This patients and grappling debilitating selection has

discovering and could costly their molecular sparing their to potentially tailor manage effective specific considering by medication it an to empower symptoms. ineffective before undergoing therapy patients clinicians profiles, trials choices numerous Importantly, treatment

by have test Academy to development data shifting with complementary launch targeted related to the Ophthalmology. you generated XXXX.Now, presented weekend American XXXX a at are with to development of Discovery date and for our to being melanoma. We providing look uveal potential the the forward in this updates focus we the test data is encouraged additional of on end

you uveal annually approximately is disease X,XXX melanoma a patients rare in with know, the U.S. diagnosed As

based the diagnosed with to In the potential test lesion presenting with very Our of dedication and be is malignant to this will currently individuals of characteristics for potential.The for standard lesions of lesions where a in prompts and it developing population, about to XX% study approach, our that on a perform small patients. change care DecisionDx-UM these watch-and-wait conducting tailored test patient such a whether biopsy. deciding and we to some current suspicious test the newly patients, uncertain is explore intervene we're ongoing decision definitively of believe prognostic clinical approach in the treat a treat suspicious we

to lesions However, intervene a that lesions treatment would have can the decision are follow of highly interventions. undertreatment any and fine clinical to allow for a our both lead been signal probably earlier is than this without test. standards or subjective of for current prognostic overtreatment simple, in to looking minimally and aggressive intervention.We to potential invasive and see biology DecisionDx-UM potentially aggressive complementary to test earlier the order as identify objective can test that We delayed

still Biosciences Our data Industry that Award, in in XX unique expect mindset. Workplaces of a Top XXXX, and early among be we share test People stages the top of securing first am Castle National type data this complementary the I third has additional awarded Castle, workplaces indicating of come recently is sector. been in that to our at discovery, whether the but healthcare culture reflects position may honored development possible.Lastly,

will financial turn now who our would details call success to without and Our their is provide possible and relating express to I not over outlook. like sincere results entire for Frank, appreciation will Castle my to contributions.I the team, the

Frank Stokes

revenue Good over growth from periods, you, third test of the XX.X% XX.X% through XXXX.Our of primarily ASP increase an in effects adjustments the XXXX. in increase the third to delivered XX% the revenue DecisionDx-Melanoma XX% clinical of robust over million, afternoon, to Thank $XX.X Derek. prior and an revenue, quarter the third was everyone.Third Overall, of increase and adoption quarter related strong reflects $XX.X was driven evidence. of revenue of during quarter in million, by growth DecisionDx-SCC was the which Adjusted quarter excludes margin third quarter XXXX. compared gross significant tests

to of for our for Our XX.X% period XXXX.Turning XX.X% to adjusted compared prior revenue and the intangible related amortization excludes was which to the with same delivered effects in acquisitions associated gross asset reports test periods, margin, quarter expenses. in the

XXXX, strong of growth, ended million third improvement EBITDA third third X XXXX. offset X share of cash marketable $X.X of XXXX, activities was with reflects investment million.Our to an XXXX, of in $XXX.X purchases quarter and $XX.X $X.XX by diluted the top compared the investment by in equivalents million activities activities quarter associated in to securities and third of for compensation cash, ending and property quarter expansions and higher to of strong. and costs of XXXX, to $XXX.X at primarily salaries R&D million the Derek within quarter expenditures expect marketable operating $X.X second third was consisted in and third expense provided due $X was clinical and of securities sales $X.X the million, the marketable more year-over-year Together compares $XX.X the million. the support million. expenses, the September up We Our in expect net The million primarily substantial million were in to primarily extend costs and our interest $X.X rates cost in stock-based marketable runway personnel and $X primarily in line totaled increased increased the to marketing higher quarter second period $X.X of by was quarter increased increase is the headcount attributable of of The net which costs, in partially per our our income ended securities third share XXXX quarter $X.X compensation, $X.XX of higher million. expense third of tests, $XX.X quarter comparable bonuses, XXXX our million expense compared $XX.X and the XXXX.Adjusted The are quarter annual of management.Net than to securities which XXXX. of to $XX Diluted our quarter XXXX, growth compared XX, continued the by to guidance of of compared the negative to associated for sales December loss third of at sales, primarily quarter equipment XXXX, for sheet from primarily per growth sales operating of stock-based expense, largest quarter total by for increased R&D compared third in to $X a which by of SG&A non-cash the $XXX the we for compared result of by million balance quarter remains was other among position million positivity.As loss XXXX disciplined $X loss investment very XXXX. for of $X.X personnel of operating the we which million improvement sales for for months This for for September $X.X million a million operating purchases of million beginning maturity in the cash expense, with XXXX. compared the studies.Total quarter XXXX.Interest year-over-year awards cash XXXX.Our we for cost mentioned, part to quarter, expenses the third and on in attributable to for for the third personnel from was least in with increased of million, of the XXXX net at million. of with of cash of that the costs including granted volume. used used third increasing equity generated our the will increase million million $XX.X driver the expenses, for quarter was $XX.X loss the with million quarter cash allocated XX, was Net XXXX XXXX operating including large of flow investing of cash quarter SG&A cash million total the was to of cash anticipated compared expense $XXX $XXX by along revenue XXXX, increased supplies operating higher purchases third of least million, through functions.Cost attributable test time months XXXX driven

increase $XX represents and make over existing will the commercial million least year. compared to growing that XX laws progress the implementing Supporting the of over effect months. that and continue expectations tests our states at this into continue at a state expect we trend about states biomarker been of Importantly, long-range our ASP with of for updated to go targets health improvements, for guidance state with laws time.Furthermore, beginning there's of an with to midpoint XX next this plans Castle's

biomarker laws initial had treatment stages, expectations.I'll flow conclusion, of impact a value highlighted adjusted still treatment a Derek. these see statement our plans the While growth, patient result in the test supporting test improvements from of the of directing we a perspective, upward we full biomarker to and of over in back financial implementation quarter operating now the positive decisions as plan applaud and as are strong the on revision results.In revenue great volume strong year biomarkers developments call a and cash in EBITDA, turn and state and legislatures a substantial governors in by and

Derek Maetzold

QX strong continued In with execution. Frank. you, Thank was quarter an exceptional summary,

our near happy remains we're create pipeline believe We're Operator? take across to the year to our to the team.Now our thanking and like Additionally, initiatives. and the quarters long your would stockholders progress I in will again questions. term performance conclude first value making excited today we Castle by for of X intact. our about our through ability

Operator

Street. question comes [Operator Instructions] today with Flaten the from Thomas line first Lake Our of

Thomas Flaten

provide not do third essentially second the if whether you TissueCypher of with on to or to volumes quarter with wondering from Pittsburgh facility quarter. the in doubling had us anything could update an was that I and

Derek Maetzold

normal completed in accept now, had scaling we're be that expectations to customers, little the a at current is think as orders sort quarter I of our And beginning end announced would the we we conference of completed from that new early. by to that we back a and everything thought mid-September of there.

normal. quarter that now reported backlog Thomas? So certainly think demand as the is second we seeing answer Does in began is question, -- that are generation that and the I running things that the

Thomas Flaten

that docs an business. even then prescribers heavily Was that's Dx-Melanoma? Or No, the there brought product Yes. new of more in coming the derm for? they I which might, in weighted great. kind distribution towards XXX you are was And were if to it of

Derek Maetzold

at look breakdown. Frank? didn't think you, Did I so. that don't I

Frank Stokes

at I it didn't that Thomas. way, look

Derek Maetzold

at of quarter. commentary earlier physicians running assumption My assume been test. also if DecisionDx-SCC, I about the third is we've that of you order XX% about is the ratio pretty there, -- in have who been ordering think consistent them melanoma that -- the

Operator

next The with of line Puneet Partners. Leerink the from question Souda comes

Puneet Souda

Congrats on strong quarter maybe Frank Derek. Maybe is this a or here.

the second that out for last parse quarter, you could SCC. And you the half. from what received you eliminated quarter in you expecting ASP I -- as the recall If had were

growth Sort the payments of of that first about should we or half come first think SCC how in in half XXXX? the could any

Frank Stokes

will We in in don't of first know the if Puneet. XXXX, half coverage be place

yes, place So during were that's be test in value to still But the we for the third quarter, correct. We of that did the determined. appropriately quarter. have for reimbursed coverage and so

Puneet Souda

you -- more produce Okay. And in I'm if attempt mean, Derek. just question and LDT implemented. think sure just Maybe us I to -- tests regulate or need their that that through a versus then broader order go FDA for the about easily through you more the was walk time easily process you where what to think regulation some data process to the market. can you had to maybe

Derek Maetzold

That's question, a Puneet. good Yes.

adequate but a Department State were our think nebulous on the of our I of through It's in clearing we and when from tests looked Health approving they approved think Both and wait we evidence approach for the proposed New a have the clarity little and to FDA's little instances, sort being test to similar of level many their In approvals. New laboratories TissueCypher and of when in laboratory reviewing or deferred all are if they we to TissueCypher's were regulate or that been, Health. that terms our in industry, once in York data data understands perspective New published FDA our a it.So more required have already PMA behind developed get timing Phoenix fact, the thing that one one we just State both than Pittsburgh will, believe the around of one, has Department at permitting of each of has I submitted York That are State my domain. rule. of laboratory more And that the diagnostic to we kinds tests laboratories they have York public permitted. and FDA specifics we tests. a certainly, it and application all have, perspective. already from test of the adequate past said, the in

feel So and smooth more I it be think what of we ahead we than pretty will to comfortable adequate process have go the a all make that for tests.

Operator

comes with Baird. next Our from question Catherine Schulte

Catherine Ramsey

cell you first, SCC the squamous guess back mentioned continuing I reimbursement to raised fourth of any prior half. the can revenue by in regarding today? guidance then Novitas earlier, as quarter? And from $XX included think guidance you but don't million, Can confirm as what you're I clarify guide the payments in you receive just assumes Puneet

portfolio, there was raised non-SCC upside or in from it was mostly third on So quarter? any the the guidance SCC

Frank Stokes

our thanks the taken value feedback guidance for out in don't the We the the question. for reimbursed Catherine, quarter. we've of that appropriately And revenue just as guidance. we product. total break we by going for forward. have the third we guidance give out We test gotten, said, were given And

from not SCC So we're here. revenue assuming forward-looking

Catherine Ramsey

on force your line portfolio? Novitas of to And all turns that draft, at derm your Okay. thoughts reimbursement? sight would unchanged on back the LCD investments for you And for I side out Got final DecisionDx-SCC. then if still change it you know But scale it. the versus you're it's appropriate for waiting until would better sales had the

Derek Maetzold

sales here. sitting We for XX, today. marketplace force, sized one, that appropriately Catherine. that handle the is people at around believe as is XX today, I'll our Yes, which current Derek of dermatology

if managers' from only one area the in wouldn't perspective. had So versus our that sizing at even two bags, test change tests we all

that's question, the think right? I Yes.

Operator

next with from Stephens. Our Carrico comes question Mason

Mason Carrico

Congrats on the quarter.

capacity and strong could that compares TissueCypher year? on how where give your where be expectation maybe So volumes, volumes some on the to you could today of color stands next TissueCypher

Frank Stokes

capacity all what sure capacity Today, we're running year. through that our next is thanks. that we're running. to make Mason, Yes. plan exceeds for and And what expectation TissueCypher exceeds

So of satisfy to we've able to ahead and got good the need be run we to want demand targets test. be where for accomplish on we're to -- we there, what to

Mason Carrico

you potentially over on commercial team Okay. you guys Great. demand want And updated the given to have many the and to team reps so? months add XX there, any next seen how that the thoughts or

Frank Stokes

Yes. there's demand we opportunity sales On given the expand test. TissueCypher, the an to think the do effort for strong there

as that be it as positive process. by the as has think physicians reception been we we discussed expected I before, to we in when were the diligence

would clinical reps they're is test, to be that value. and next so It's value great that as and get year Probably a sales of first those the capacity half the now in and lab a to current expanded productive. the explaining online when option the in got we we've doing we've that some improvement And an of to feel well, great got an job some and team so expand and in that target lab is I beginning good about modest force. physicians, obviously investment embracing sales

will judicious, to cautious and an franchise. do So we'll we'll add be be be the believe more but in opportunity to we resources our marketing there effort GI

Operator

question next comes Genuity. Canaccord Kyle Mikson Our with from

Unknown Analyst

on This Congrats I'm Great ]. on the update, for guys. Kyle performance. is [ Alex Mikson. Dukasin

getting Just the kind reimbursement. back of to and DecisionDx-SCC

comment any that of the the that you were previously obviously, new I ended reenter was just simply you prior if X. context we used data regarding I period. know or September to period. comment the to able curious perhaps roughly any organized with ending talks So new data

Derek Maetzold

think I --

Frank Stokes

ended? comment question has the data we is The period can add since more

Unknown Analyst

comment since the before Essentially, period Yes. and the last I ended, guess, update.

Derek Maetzold

submit Novitas guess, our part with did data presented that to was early in I we new in the, September comments August. of earlier So

including data I X sets. data the was most data or think set submitted, So new important

study may to That's or them to of no SCC we for other patients will or radiation response radiation marketplace no the submitted who a tests is that groups during data meeting presented patients, factor right our One comment to patient though important now one think therapy which likely receive benefit.The within or discern every to likely a from use are large test, of subgroups And subgroups in or subgroups, -- benefit that factors. was be the risk adjuvant different and open have one seen of patients, they are actually population understand, have to who which advance therapy. nice similarly the also find who a patients, more factors help examine in risk adjuvant is adds appropriate of basically that therapy, to different substages how able now radiation benefit of nobody patients, important medical various XXX the reviewers our those has it tests in and eligible risk value our to the for clinical even being those response with appreciate also of element get people information an to I might we performed.

Unknown Analyst

And one other level kind here. question of high

over was see market's time? over of that you how penetrated So you I like at this could it increasing evolve you feel you discussed to market the penetration XXXX, curious roughly level feel XX% level how currently. will what

Derek Maetzold

Yes.

continue see reason or about of kind think we've months X.X% XX of we I maybe that in that Maybe penetration progress X%. or years, what, X.X% We every X% hit until in not market growth So last is no penetration. maybe to won't why to XX%, XX% of XX%, XX kind the seen, XX, X%, X.X% couple to so, right?

was go that there.Now good think or the got about, might quarter, I I more next that recent ramp to late that we the think data a grow published guess right? we've second question what I rapidly believe is in et patients well talked from runway year, the in peers say, should both script, adopted Dillon, more higher So that from the they longer the the prepared al., the can of your X our test as as use paper live SEER NCI doctor paper them. their when didn't are tests, than when where I that about you hey, elements cause

patients receive I your as a you want if ask to that would that's well. something benefit you Now from would

than mind of to expect I what of seen which time or accelerate what in and the data, will the trends. we next couple be our to bit might So would year. work past I that surgical for help dermatology top is in higher years a that would think customers think kind that colleagues, previous take But we've me that into of

Operator

Our Mark next from with BTIG. question Massaro comes

Mark Massaro

Congrats you think Palmetto wanted lot current and can to on terrific quarter. helpful on there's -- steps? just and interesting get you what an guess provided on if obviously, a -- contractors about timing to Novitas, Novitas. of policies changes WPS, -- when your ask what I next on are on are expectations discussions from potential we do for especially been the would Medicare any update be the multiple it And Palmetto SCC? maybe a I

Derek Maetzold

kind goes it's based go XXX would seen with So just and away. very or upon posted rules are rarely be reviews faster historical of you trends after or by it infrequently rules. we than the finalize to or have days a LCD the Medicare what Palmetto, retires final need required And post Medicare

is So you data, in track LCD year. data and roughly a a Palmetto, if cases, is about proposed is finalized, that the just most the

of would a updating nearly mean the of that's as developing timing for of of that's have could operated the of new usually as robust they go in have out May probably So next how or but character kind they is that LCDs past.Novitas, history year Palmetto. faster, don't that. They really right

that's that. around So a to harder get handle

XX well. If Mark. about kind months, proposed the XX.X potentially a you Would just year number the follow outside with what months LCD, same there, the proposed ago take That's was pathway? as they initial had that of they

Mark Massaro

I super revenue here. what thought squamous -- expecting process? I you're informs guess, that then not cell That's guidance, think you from helpful. Okay. indicated that in you And your

Frank Stokes

folks, We that significant that of some the a from feedback some around the uncertainty given investors approach would our underway, got processes well most conservative guide. number to Mark, take that LCD analysts be are and of that the out as

And so we've taken that advice.

Mark Massaro

Last Makes perfect for me. question sense.

maybe trends -- What strong TissueCypher. is it this What view, you you Can similar going see mean about, some guys to job growth. a You doing of And really in what I think do your are the forward? just driving is with drivers here? great this? a path is talk you are XXX%-plus

Derek Maetzold

large think the medical X year. or of X We maybe down population had are would diligence, that of showing more doing break every we a it I being patients patients. or Mark. it's One that's into elements, is over newly When So out rescoped either diagnosed XXX,XXX was who we're data seen, XXX,XXX. numbers claim like

large, gastroenterologists So on a one, I patient seeing basis. it's that underserved just a is regular group think

seen in for the in endoscopy surveillance. coming or the for either Barrett's office the, being newly back or repeat are suite their esophagus, either diagnosed patients So

is That most patient So the FDA-approved manufactures. been to sort have own goal.Now I share do or called trials tools. The has Barrx, killing at highest now Barrett's think dysplasia shown than important approval and is market most is esophagus FDA have progression higher who that the sort TissueCypher that in high-grade the when to risky low-grade it risk sort is which is disease over two I all includes people one cancer, have last that's you highly limit we they of then non-dysplastic the there.I to risk though who test the dysplasia. one effective for forward, of population people which Medtronic years think a is and don't a have say, you be the to do well, of XX off that, progress kind even the its tool B-A-R-X-X, should clinical The ablation they devices, which number have with actually guidelines flow really lowest really, going society able group, -- think people find And lesions. dysplasia, historically, markets even of dysplasia. take disease, grades maybe of and low-grade

easy gastroenterologist own I for fairly in in just was have that cancer It who visits. a says just esophagus it's So me. to Barrett's practice a between where kills linkage I my progressed lesion non-dysplastic patients so their surprised

non-dysplastic progressing. population on those XX% cancer that need treated the makes there who the aren't the of say, effective to overall progress up of So recognize about to have patient people and ones a because to which other tool getting that hand find they're group I now my an they chance eradicate but all who large patients in there's and most the of

that an it's of sort patients. can have a easy And they'd of high that that seen tool available all needs unmet they've experienced their go like So already the need clinical they train ahead to racks catch. and and meet

that's initially we think first in for So terms product. the were XXXX, were this of the second January timing, We in purposes. variety also third that They for looking element.In if we dial team you'll status sales obtaining back year, the hired last to of ADLT up of I quarter. quarter recall largely in training of at first

team And to year. think at have around for go so months it right been quarter That takes effective. to the fully sales we our be of would of third X last kind

We from also XXXX. to reps sales XX in XX the expanded of fall

the demand very, forward. a XXX volume And good getting that so and starting quarter I good was feet reports for test the very just from essentially just was this just going think going. team reflects a and solid its engine And

Mark Massaro

color. the all appreciate I Excellent.

Operator

back We to remarks. Derek further turn have no the questions. closing I'll call for

Derek Maetzold

in today joining continued concludes Thank Thank for for us your Castle our earnings XXXX call. third quarter you Biosciences. interest you, This and operator. again

Operator

today. and your disconnect for This lines. everyone, joining you, Thank now concludes may our call, you us

Castle Biosciences (CSTL) 2 Nov 232023 Q3 Earnings call transcript