01 - Bring a large pot of salted water to a boil. Cook pasta according to package instructions until al dente. Reserve 1/2 cup of pasta water, then drain.
02 - While the pasta cooks, heat olive oil in a large skillet over medium heat. Sauté onion until translucent, about 3–4 minutes. Add garlic and cook for 1 minute until fragrant.
03 - Pour in the crushed tomatoes, oregano, salt, pepper, and sugar (if using). Simmer for 10 minutes, stirring occasionally.
04 - Reduce heat to low. Stir in heavy cream and Parmesan, simmering gently for 2–3 minutes until sauce is creamy and slightly thickened.
05 - Add drained pasta to the sauce, tossing to coat. If needed, add reserved pasta water a little at a time until desired sauce consistency is reached.
06 - Remove from heat. Stir in fresh basil.
07 - Serve immediately, topped with extra Parmesan and more fresh basil if desired.