Acalabrutinib and Venetoclax With or Without Early Obinutuzumab for the Treatment of High Risk, Recurrent, or Refractory Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

This study is testing a combination of two targeted drugs — acalabrutinib and venetoclax, with or without a third drug called obinutuzumab — for treating chronic lymphocytic leukemia (CLL), a type of blood cancer. It includes both newly diagnosed patients and those whose cancer has come back or stopped responding to treatment. **You may be eligible if...** - You are 18 or older - You have been diagnosed with CLL or small lymphocytic lymphoma (SLL) and need treatment - If newly diagnosed: you have high-risk features or are 65 or older - If previously treated: your cancer relapsed or did not respond to at least one prior therapy - Your kidneys and liver are functioning adequately **You may NOT be eligible if...** - You have certain genetic mutations that make these drugs less effective (e.g., certain BCL2 mutations) - You have active infections like hepatitis B or C, or HIV - You have uncontrolled heart rhythm problems - You need certain blood thinners that cannot be safely paused Talk to your doctor to see if this trial is right for you.