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Heat olive oil in a large skillet over medium-high heat.
Add guanciale and red pepper flakes. Cook until browned.
Deglaze with white wine and simmer until reduced.
Stir in crushed tomatoes and bring to a simmer.
Cook pasta until 1 minute shy of al dente.
Transfer pasta to sauce with ¼ cup pasta water.
Stir over high heat until sauce thickens and coats noodles.
Remove from heat. Stir in Pecorino Romano until creamy.
Serve hot, passing more cheese at the table.