Lightly coat a large cast iron skillet or sauté pan with olive oil and place over medium-low heat.
Add pancetta and slowly cook for about 5 minutes to begin rendering the fat.
Add sliced shallot and continue cooking for approximately another 5 minutes, until translucent and lightly golden. At this point, start bringing your salted pasta water to a boil.
Add butter, garlic, crushed red pepper, a small pinch of salt and cracked black pepper. Sauté over medium-low until the garlic becomes fragrant and slightly golden.
Add tomato paste and cook it into the pancetta mixture, stirring continuously with a wooden spoon.
Deglaze the pan with vodka. Stir and scrape up all the flavorful bits from the bottom.
Add the canned cherry tomatoes. Gently pop the tomatoes with your wooden spoon, leaving some pieces partially intact for texture.
Bring the tomato mixture briefly to a boil.
Pour heavy cream into the empty tomato can, stir to pick up the remaining tomato, then pour it into the skillet.
Stir and briefly bring to a boil, then immediately reduce to a simmer.
Meanwhile, cook fusilli until almost al dente.
When the pasta is nearly al dente, reserve 1 cup of the very starchy pasta water and stir it into the sauce. Briefly bring the sauce up, then reduce back to a simmer.
Stir in ½ cup freshly grated Pecorino Romano.
Transfer the fusilli directly from the pasta water into the sauce using a spider strainer. Toss until every piece is thoroughly coated.
Add fresh basil and toss again.
Taste for seasoning and adjust salt, pepper and crushed red pepper as needed.
Serve immediately with plenty of additional freshly grated Pecorino Romano.