01 - Bring a large pot of salted water to a boil. Cook pasta according to package instructions until al dente. Reserve ½ cup pasta water, then drain.
02 - Heat olive oil in a large skillet over medium heat. Sauté onion for 3 to 4 minutes until translucent. Add garlic and cook for 1 minute until fragrant.
03 - Add crushed tomatoes, tomato paste, sugar, oregano, chili flakes if using, salt, and pepper to the skillet. Simmer for 10 minutes, stirring occasionally.
04 - Reduce heat, stir in heavy cream and grated Parmesan. Simmer for 2 to 3 minutes until sauce is creamy and heated through.
05 - Add drained pasta to sauce and toss to coat evenly. Add reserved pasta water as needed to adjust sauce consistency.
06 - Plate immediately and garnish with fresh basil and additional Parmesan if desired.