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Derek Maetzold is the founder, President, and CEO of Castle Biosciences, a leading diagnostics company dedicated to improving health through its innovative tests that guide patient care. Primarily focused on dermatologic cancers and gastroenterological disease, the Company’s proprietary molecular tests are designed to help answer critical clinical questions and address treatment plan challenges facing clinicians to better inform patient care decisions.
Transformative Leadership in Precision Medicine
In 2007, Derek took a leap of faith that helped transform the care of patients with certain cancers and ultimately impacted hundreds of thousands of patients. Leaving behind a secure 20-year career in pharmaceuticals, Derek founded Castle Biosciences with a visionary goal: to personalize disease management by leveraging a patient's unique biology to better inform clinical decision-making.
This vision was not without risk. As the 2008 financial crisis unfolded, Derek invested his personal savings and persevered through financing challenges when others might have retreated to safer corporate positions. His unwavering belief that molecular diagnostic technologies could revolutionize patient care propelled him forward, despite these obstacles. In June 2024, Derek was recognized by Ernst & Young as an Entrepreneur Of The Year® Gulf South Award winner for his ingenuity, courage, and entrepreneurial spirit.
Building a Purpose-Driven Enterprise
Derek has grown Castle Biosciences from three employees to more than 750 across the U.S. Under his leadership, Castle has maintained exceptional financial performance, reaching revenue of $332 million in 2024 (51% growth over 2023). 2023 revenue reached $219.8 million (60% growth over 2022).
Castle delivered 96,071 test reports in 2024 (36% growth over 2023) and delivered 70,429 test reports in 2023 (59% growth over 2022). These results highlight the growing adoption of Castle’s tests: each report represents a patient receiving more personalized care, reinforcing the real-world difference the Company’s tests can make in improving patient outcomes.
Strategic Portfolio Diversification
Understanding the challenges inherent in the diagnostics industry, Derek diversified Castle's test offerings to help ensure long-term stability while maximizing patient impact.
Castle’s journey began with licensing DecisionDx-UM for the rare uveal melanoma. Determined to help more patients, Derek assembled a team to develop DecisionDx-Melanoma, launched in 2013 as the first test to risk-stratify skin melanoma. This groundbreaking test has now been ordered more than 191,000 times by more than 14,500 clinicians (as of 12/31/24), reinforcing its value in clinical decision-making and patient care.
Derek strategically acquired additional tests, including MyPath Melanoma and TissueCypher, each addressing critical unmet clinical needs and positively impacting patient care. Castle now offers six molecular tests leveraging advanced technologies and artificial intelligence.
Tangible Patient Impact
Derek's leadership has profoundly transformed patient care. Castle's DecisionDx-Melanoma test, for example, helps accurately stratify patients based on their risk of dying from melanoma — the deadliest form of skin cancer1 — enabling more personalized management decisions that can lead to better patient outcomes. Similarly, the TissueCypher test leverages AI and spatialomics to identify Barrett’s esophagus patients at high risk of progressing to high-grade dysplasia or esophageal adenocarcinoma — a cancer that claims the lives of ~80% of those diagnosed.2 By enabling early intervention before cancer develops, this technology has the potential to save lives.
Values-Driven Culture
Despite rapid growth, Derek has maintained Castle's founding principles: doing what's best for patients, valuing employees, and pursuing excellence. This people-first approach has fostered a thriving company culture that has earned the company four consecutive Top Workplaces USA awards, including the 2025 designation (official announcement 3/20/25).
A Legacy of Innovation
Derek Maetzold's legacy lies in his courageous entrepreneurial spirit, his strategic vision for precision medicine, and his unwavering commitment to improving healthcare. By pioneering innovative tests that guide patient care decisions for diseases with unmet clinical needs, he has created both a successful business and a vehicle for transforming countless lives. His career exemplifies how business leadership, when guided by purpose and persistence, can create lasting positive change in healthcare.
Nomination Title: Derek Maetzold
