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Add the oil to a large saucepan over low to medium heat and heat it up for 1 to 2 minutes.
Next, add in the pancetta and cook it until it becomes crispy and browned. This will take about 5 to 7 minutes.
Remove the pancetta and set it to the side.
In the pan with the hot oil, add in the onions and cook while frequently stirring until browned. This will take about 8 to 10 minutes.
Next, add in the peppers and sauté for 1 to 2 minutes.
Add the pancetta back to the pan and stir to combine.
Turn the heat to low and deglaze with the vodka. Then, turn the heat up to medium.
Stir and cook the vodka down until the amount of liquid is reduced to a few tablespoons.
Pour in the tomatoes and cook for 8 to 10 minutes to reduce the amount of liquid. See the video for what to look for. Turn the heat off.
Drop the penne pasta into a large pot of boiling salted water and cook for 7 to 8 minutes or until al dente.
While the pasta is cooking, add the cream to the tomato sauce, along with salt and pepper, and stir to combine. Set aside.
Drain the pasta and add it to the saucepan.
Add in pecorino Romano cheese, fresh basil, salt, and pepper, and stir to combine.
You may need to add in ½ cup of hot pasta water to help loosen up the pasta.
Serve the pasta with additional cheese and crushed red pepper flakes