Treatment-related adverse effects of any grade , which occurred in more than 40 % of patients in the lenvatinib group , were hypertension ( in 67.8 % of the patients ) , diarrhea ( in 59.4 % ) , fatigue or asthenia ( in 59.0 % ) , decreased appetite ( in 50.2 % ) , decreased weight ( in 46.4 % ) , and nausea ( in 41.0 % ) .