#!/usr/bin/perl
use strict;
use warnings;
use CAM::PDF;

my $pdf = CAM::PDF->new('test.pdf');
my $pagecontent = $pdf->getPageContent(1);

# $pagecontent now holds the text within the first page.
# say I want to replace the word Release with Distribution.

$pagecontent =~ s/Release/Distribution/;

$pdf->setPageContent(1, $pagecontent);
$pdf->cleanoutput('test_replace.pdf');