Start by bringing a large pot of salted water to a boil. Add the ziti noodles and cook according to package instructions until very al dente, about 7 minutes. Drain and return the pasta to the pot.

Preheat your oven to 425°F (220°C) and position the rack in the middle.

Heat a large sauté pan over medium-high heat. Crumble the Italian sausage into the pan and cook until browned and cooked through, about 5 to 6 minutes. Transfer to a plate, draining all but 1 tablespoon of the fat.

Add minced garlic to the pan and stir constantly for about 1 minute, until soft but not brown. Pour in the crushed tomatoes, salt, sugar, and crushed red pepper flakes, then simmer uncovered for 10 minutes.

Stir in heavy cream, ⅓ cup of grated pecorino Romano, cooked sausage, and fresh basil until combined. Pour this mixture over the pasta, gently stirring to combine.

Spoon half of the pasta mixture into a 9 x 13-inch baking dish, sprinkle with half of the shredded mozzarella and remaining pecorino Romano cheese. Layer the rest of the pasta mixture on top, followed by the remaining mozzarella and pecorino.

Transfer to the oven and bake uncovered until the cheese is melty and golden, about 15 to 20 minutes.

Once baked, sprinkle with additional fresh basil and serve hot.