TissueCypher abstract awarded a Presidential Poster Award by ACG Abstract Selection Committee, a distinction awarded to only 5-7% of abstracts for high quality, novel, unique or interesting research

Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, today announced new data demonstrating a significant reduction in healthcare management costs and an improvement in the quality of life for patients with Barrett’s esophagus (BE) whose management is guided by its TissueCypher test. The data was presented at the 2024 American College of Gastroenterology (ACG 2024) Annual Scientific Meeting, being held Oct. 25-30, in Philadelphia.

“Our team from four different academic medical centers collaborated to evaluate the cost-effectiveness of TissueCypher in guiding surveillance and treatment of Barrett’s esophagus,” said Cadman L. Leggett, M.D., Division of Gastroenterology at Mayo Clinic in Rochester, Minnesota. “Using a Markov decision and microsimulation model for 10,000 patients, our results demonstrated that the cost of managing BE decreased by $17M if patients identified by TissueCypher to be at risk of cancer progression were to receive endoscopic eradication therapy (EET). More importantly, TissueCypher-guided care reduced the incidence of esophageal cancer progression by 58.4% when patients with intermediate or high-risk TissueCypher scores receive EET.”

More than 5,100 scientific abstracts will be presented during ACG 2024. Only a small percentage of these, including Castle’s TissueCypher poster, received a Presidential Poster Award, recognizing high quality, novel, unique or interesting research. Details regarding Castle’s award-winning poster are included below:

P3924. (S702). Risk-Aligned Management Guided by the Tissue Systems Pathology Test Can Improve Health Outcomes in Barrett’s Esophagus and Reduce Healthcare-Associated Costs

  • Key takeaways:
    • This study evaluated the cost-effectiveness of TissueCypher-guided management for patients with BE.
    • The data demonstrated that care guided by the test can significantly reduce patient management costs due to de-escalated care for patients with low-risk test results (e.g., reduced overutilization of surveillance and EET) and escalated care for patients with higher-risk test results (e.g., earlier use of EET to prevent development of high-grade dysplasia/esophageal adenocarcinoma (HGD/EAC) and increased surveillance).
    • In addition to significant cost savings to the healthcare system, the study highlights how care guided by the TissueCypher test can improve patient quality of life and health outcomes, as well as contribute to a significant reduction in the incidence of HGD/EAC by 58.4% and EAC-related death by 59.6%.

To view the full poster, visit the ACG 2024 ePoster Hall. To learn more about TissueCypher, visit Castle at booth 1083.

About TissueCypher® Barrett’s Esophagus Test

The TissueCypher Barrett’s Esophagus test is Castle’s precision medicine test designed to predict future development of high-grade dysplasia (HGD) and/or esophageal cancer in patients with Barrett’s esophagus (BE). The TissueCypher Barrett’s Esophagus test is indicated for use in patients with endoscopic biopsy-confirmed BE that is graded non-dysplastic (NDBE), indefinite for dysplasia (IND) or low-grade dysplasia (LGD); its clinical performance has been supported by 14 peer-reviewed publications of BE progressor patients with leading clinical centers around the world. The test received Advanced Diagnostic Laboratory Test (ADLT) status from the Centers for Medicare & Medicaid Services (CMS) in March 2022. Learn more at www.CastleBiosciences.com.

About Castle Biosciences

Castle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving health through innovative tests that guide patient care. The Company aims to transform disease management by keeping people first: patients, clinicians, employees and investors.

Castle’s current portfolio consists of tests for skin cancers, Barrett’s esophagus, mental health conditions and uveal melanoma. Additionally, the Company has active research and development programs for tests in other diseases with high clinical need, including its test in development to help guide systemic therapy selection for patients with moderate-to-severe atopic dermatitis, psoriasis and related conditions. To learn more, please visit www.CastleBiosciences.com and connect with us on LinkedIn, Facebook, X and Instagram.

DecisionDx-Melanoma, DecisionDx-CMSeq, i31-SLNB, i31-ROR, DecisionDx-SCC, MyPath Melanoma, DiffDx-Melanoma, TissueCypher, IDgenetix, DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences, Inc.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the “safe harbor” created by those sections. These forward-looking statements include, but are not limited to, statements concerning: the ability of the TissueCypher test to (i) significantly reduce healthcare management costs and improve the quality of life and health outcomes for patients with BE and (ii) contribute to a significant reduction in the incidence of HGD/EAC. The words “can,” “would” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements that we make. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation: subsequent study or trial results and findings may contradict earlier study or trial results and findings or may not support the results shown in this study, including with respect to the discussion of TissueCypher in this press release; actual application of our TissueCypher test may not provide the aforementioned benefits to patients; and the risks set forth under the heading “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2023, our Quarterly Report on Form 10-Q for the quarter ended June 30, 2024 and in our other filings with the SEC. The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements, except as may be required by law.

Investor Contact: Camilla Zuckero czuckero@castlebiosciences.com Media Contact: Allison Marshall amarshall@castlebiosciences.com

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