Abstract Perineural invasion (PNI) is a crucial mechanism facilitating prostate cancer metastasis. PNI encompasses perineural, circumferential, and intraneural invasion, with cancer cells closely interacting with nerves. Evidence suggests that cancer cells utilize the nervous system for metastasis through signaling pathways. PNI is associated with poor prognoses in various cancers, but its role in prostate cancer remains unclear. PCa primarily metastasizes through systemic routes, such as lymphatic and circulatory systems. Metastasizing cancer cells undergo epithelial-mesenchymal transition (EMT), enhancing their motility. SNAIL1, a transcriptional repressor, induces EMT and promotes cancer cell migration, including towards nerves, termed neurite outgrowth. Neurite outgrowth involves intricate signaling between tumor cells and nerves, possibly facilitating cancer cell infiltration into nerve sheaths and PNI. Our lab has shown SNAIL1 in interactions with neurotrophic factors like Brain-Derived Neurotrophic Factor (BDNF) and Tyrosine Kinase Receptor Beta (TrkB), modulating cancer cell behavior. TrkB is overexpressed in various cancers, while BDNF signaling contributes to EMT via the Twist-Snail axis. BDNF may also play a role in PNI pathogenesis. Our hypothesis posits the BDNF-TrkB axis drives aggressive prostate cancer and PNI. This study employed prostate cancer cell lines for comprehensive analysis. We assessed BDNF expression in different cell lines, particularly those with high Snail levels, and analyzed BDNF transcript levels via real-time quantitative PCR following RNA extraction and reverse transcription. We explored whether BDNF overexpression enhanced cancer cell migration towards nerves, employing migration assays. Our findings indicated heightened migration in BDNF-high cell lines, C42, PC3, and MDA-2b, compared to BDNF knockdown cells. Additionally, a TrkB inhibitor, K252a, attenuated migration due to BDNF-induced TrkB phosphorylation. Our study establishes that BDNF/TrkB signaling promotes prostate cancer cell migration towards nerves, a phenomenon reversible with K252a, offering a potential strategy to impede prostate cancer progression and metastasis. Citation Format: Gabrielle Joy Edwards, Valerie Odero-Marah. BDNF/TrKB signaling may lead to higher incidence of perineural invasion in men with prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5414.